National Provider Identifier [NPI]: |
1023036670 |
Last Name Of The Provider |
GERARD |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
201 S BUENA VISTA ST |
Street Address 2 Of The Provider |
SUITE # 250 |
City Of The Provider |
BURBANK |
Zip Code Of The Provider |
915054569 |
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 |
62 |
Number Of Services |
1753 |
Number Of Medicare Beneficiaries |
208 |
Total Submitted Charge Amount |
143753 |
Total Medicare Allowed Amount |
93486.87 |
Total Medicare Payment Amount |
70112.24 |
Total Medicare Standardized Payment Amount |
66232.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
280 |
Number Of Medicare Beneficiaries With Drug Services |
144 |
Total Drug Submitted ChargeAmount |
10516 |
Total Drug Medicare AllowedAmount |
4118.37 |
Total Drug Medicare PaymentAmount |
3901.75 |
Total Drug Medicare Standardized Payment Amount |
3901.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
1473 |
Number Of Medicare Beneficiaries With Medical Services |
207 |
Total Medical Submitted Charge Amount |
133237 |
Total Medical Medicare Allowed Amount |
89368.5 |
Total Medical Medicare Payment Amount |
66210.49 |
Total Medical Medicare Standardized Payment Amount |
62330.89 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
193 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.968 |