National Provider Identifier [NPI]: |
1578677951 |
Last Name Of The Provider |
ROBERTS |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2476 OVERLAND AVE |
Street Address 2 Of The Provider |
SUITE 305 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900643370 |
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 |
19 |
Number Of Services |
231 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
203700 |
Total Medicare Allowed Amount |
43188.2 |
Total Medicare Payment Amount |
33455.86 |
Total Medicare Standardized Payment Amount |
33657.93 |
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 |
19 |
Number Of Medical Services |
231 |
Number Of Medicare Beneficiaries With Medical Services |
228 |
Total Medical Submitted Charge Amount |
203700 |
Total Medical Medicare Allowed Amount |
43188.2 |
Total Medical Medicare Payment Amount |
33455.86 |
Total Medical Medicare Standardized Payment Amount |
33657.93 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
191 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
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 |
206 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8648 |