National Provider Identifier [NPI]: |
1457513178 |
Last Name Of The Provider |
MONGE |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
26800 CROWN VALLEY PKWY |
Street Address 2 Of The Provider |
SUITE 315 |
City Of The Provider |
MISSION VIEJO |
Zip Code Of The Provider |
926916384 |
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 |
18 |
Number Of Services |
1118 |
Number Of Medicare Beneficiaries |
368 |
Total Submitted Charge Amount |
205214.75 |
Total Medicare Allowed Amount |
147315.97 |
Total Medicare Payment Amount |
114753.43 |
Total Medicare Standardized Payment Amount |
107138.02 |
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 |
18 |
Number Of Medical Services |
1118 |
Number Of Medicare Beneficiaries With Medical Services |
368 |
Total Medical Submitted Charge Amount |
205214.75 |
Total Medical Medicare Allowed Amount |
147315.97 |
Total Medical Medicare Payment Amount |
114753.43 |
Total Medical Medicare Standardized Payment Amount |
107138.02 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
118 |
Number Of Female Beneficiaries |
204 |
Number Of Male Beneficiaries |
164 |
Number Of Non Hispanic White Beneficiaries |
325 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
307 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.1625 |