National Provider Identifier [NPI]: |
1134175540 |
Last Name Of The Provider |
MACARUBBO |
First Name Of The Provider |
MARIE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 COFFEE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MODESTO |
Zip Code Of The Provider |
953554201 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1828 |
Number Of Medicare Beneficiaries |
591 |
Total Submitted Charge Amount |
335159.6 |
Total Medicare Allowed Amount |
131760.13 |
Total Medicare Payment Amount |
90341.69 |
Total Medicare Standardized Payment Amount |
87872.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
341 |
Number Of Medicare Beneficiaries With Drug Services |
214 |
Total Drug Submitted ChargeAmount |
8301.6 |
Total Drug Medicare AllowedAmount |
4612.69 |
Total Drug Medicare PaymentAmount |
4478.97 |
Total Drug Medicare Standardized Payment Amount |
4478.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
1487 |
Number Of Medicare Beneficiaries With Medical Services |
560 |
Total Medical Submitted Charge Amount |
326858 |
Total Medical Medicare Allowed Amount |
127147.44 |
Total Medical Medicare Payment Amount |
85862.72 |
Total Medical Medicare Standardized Payment Amount |
83393.2 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
268 |
Number Of Beneficiaries Age 75 to 84 |
165 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
411 |
Number Of Male Beneficiaries |
180 |
Number Of Non Hispanic White Beneficiaries |
463 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
24 |
Number Of Hispanic Beneficiaries |
84 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
435 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.0472 |