National Provider Identifier [NPI]: |
1225075518 |
Last Name Of The Provider |
STELMAN |
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 |
2967 LOMA VISTA RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
VENTURA |
Zip Code Of The Provider |
930032915 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
876 |
Number Of Medicare Beneficiaries |
170 |
Total Submitted Charge Amount |
111617 |
Total Medicare Allowed Amount |
83598.44 |
Total Medicare Payment Amount |
58452.5 |
Total Medicare Standardized Payment Amount |
53464.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
60 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
2673 |
Total Drug Medicare AllowedAmount |
1440.79 |
Total Drug Medicare PaymentAmount |
1401.97 |
Total Drug Medicare Standardized Payment Amount |
1401.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
816 |
Number Of Medicare Beneficiaries With Medical Services |
170 |
Total Medical Submitted Charge Amount |
108944 |
Total Medical Medicare Allowed Amount |
82157.65 |
Total Medical Medicare Payment Amount |
57050.53 |
Total Medical Medicare Standardized Payment Amount |
52062.36 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
86 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
144 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
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 |
15 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9626 |