National Provider Identifier [NPI]: |
1114162682 |
Last Name Of The Provider |
DESILVA |
First Name Of The Provider |
MAHESH |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 S. MAIN STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
CORONA |
Zip Code Of The Provider |
92882 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
110 |
Number Of Medicare Beneficiaries |
74 |
Total Submitted Charge Amount |
110184 |
Total Medicare Allowed Amount |
24662.44 |
Total Medicare Payment Amount |
19335.3 |
Total Medicare Standardized Payment Amount |
19296.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
110 |
Number Of Medicare Beneficiaries With Medical Services |
74 |
Total Medical Submitted Charge Amount |
110184 |
Total Medical Medicare Allowed Amount |
24662.44 |
Total Medical Medicare Payment Amount |
19335.3 |
Total Medical Medicare Standardized Payment Amount |
19296.7 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
23 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
28 |
Number Of Non Hispanic White Beneficiaries |
42 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
40 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
|
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.3594 |