National Provider Identifier [NPI]: |
1407176670 |
Last Name Of The Provider |
MIN |
First Name Of The Provider |
MYO |
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 |
1600 N ROSE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
OXNARD |
Zip Code Of The Provider |
930303722 |
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 |
14 |
Number Of Services |
987 |
Number Of Medicare Beneficiaries |
402 |
Total Submitted Charge Amount |
290579 |
Total Medicare Allowed Amount |
103067.3 |
Total Medicare Payment Amount |
79201.62 |
Total Medicare Standardized Payment Amount |
75438.77 |
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 |
14 |
Number Of Medical Services |
987 |
Number Of Medicare Beneficiaries With Medical Services |
402 |
Total Medical Submitted Charge Amount |
290579 |
Total Medical Medicare Allowed Amount |
103067.3 |
Total Medical Medicare Payment Amount |
79201.62 |
Total Medical Medicare Standardized Payment Amount |
75438.77 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
207 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
178 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
33 |
Number Of Hispanic Beneficiaries |
172 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
193 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
209 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.485 |