National Provider Identifier [NPI]: |
1225045149 |
Last Name Of The Provider |
BUI |
First Name Of The Provider |
PENNA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20103 LAKE CHABOT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CASTRO VALLEY |
Zip Code Of The Provider |
945465305 |
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 |
52 |
Number Of Services |
256 |
Number Of Medicare Beneficiaries |
220 |
Total Submitted Charge Amount |
214620 |
Total Medicare Allowed Amount |
55986.4 |
Total Medicare Payment Amount |
43837.66 |
Total Medicare Standardized Payment Amount |
42047.43 |
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 |
52 |
Number Of Medical Services |
256 |
Number Of Medicare Beneficiaries With Medical Services |
220 |
Total Medical Submitted Charge Amount |
214620 |
Total Medical Medicare Allowed Amount |
55986.4 |
Total Medical Medicare Payment Amount |
43837.66 |
Total Medical Medicare Standardized Payment Amount |
42047.43 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
126 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
110 |
Number Of Black or African American Beneficiaries |
40 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
115 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.3488 |