National Provider Identifier [NPI]: |
1346251550 |
Last Name Of The Provider |
COREY |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3626 RUFFIN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921231810 |
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 |
58 |
Number Of Services |
209 |
Number Of Medicare Beneficiaries |
116 |
Total Submitted Charge Amount |
209700 |
Total Medicare Allowed Amount |
50268.85 |
Total Medicare Payment Amount |
39014.22 |
Total Medicare Standardized Payment Amount |
39029.08 |
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 |
58 |
Number Of Medical Services |
209 |
Number Of Medicare Beneficiaries With Medical Services |
116 |
Total Medical Submitted Charge Amount |
209700 |
Total Medical Medicare Allowed Amount |
50268.85 |
Total Medical Medicare Payment Amount |
39014.22 |
Total Medical Medicare Standardized Payment Amount |
39029.08 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
64 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
74 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
10 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.6685 |