National Provider Identifier [NPI]: |
1588608749 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
ROGER |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
ONE HOAG DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWPORT BEACH |
Zip Code Of The Provider |
926634162 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
125 |
Number Of Services |
2271 |
Number Of Medicare Beneficiaries |
1613 |
Total Submitted Charge Amount |
144409.33 |
Total Medicare Allowed Amount |
36825.36 |
Total Medicare Payment Amount |
28263.31 |
Total Medicare Standardized Payment Amount |
26334.89 |
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 |
125 |
Number Of Medical Services |
2271 |
Number Of Medicare Beneficiaries With Medical Services |
1613 |
Total Medical Submitted Charge Amount |
144409.33 |
Total Medical Medicare Allowed Amount |
36825.36 |
Total Medical Medicare Payment Amount |
28263.31 |
Total Medical Medicare Standardized Payment Amount |
26334.89 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
565 |
Number Of Beneficiaries Age 75 to 84 |
532 |
Number Of Beneficiaries Age Greater 84 |
389 |
Number Of Female Beneficiaries |
891 |
Number Of Male Beneficiaries |
722 |
Number Of Non Hispanic White Beneficiaries |
1425 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
86 |
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
26 |
Number Of Beneficiaries With Medicare Only Entitlement |
1394 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
219 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8939 |