National Provider Identifier [NPI]: |
1033220611 |
Last Name Of The Provider |
ROSS |
First Name Of The Provider |
PHILLIP |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
350 30TH ST |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
OAKLAND |
Zip Code Of The Provider |
946093424 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
1691 |
Number Of Medicare Beneficiaries |
390 |
Total Submitted Charge Amount |
790797.5 |
Total Medicare Allowed Amount |
207168.95 |
Total Medicare Payment Amount |
154931.71 |
Total Medicare Standardized Payment Amount |
135666.89 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
205 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
265 |
Number Of Non Hispanic White Beneficiaries |
227 |
Number Of Black or African American Beneficiaries |
79 |
Number Of AsianPacific Islander Beneficiaries |
32 |
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
268 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
122 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1189 |