National Provider Identifier [NPI]: |
1023054798 |
Last Name Of The Provider |
WOODARD |
First Name Of The Provider |
ROGER |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12401 WASHINGTON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WHITTIER |
Zip Code Of The Provider |
906021006 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
307 |
Number Of Medicare Beneficiaries |
270 |
Total Submitted Charge Amount |
169001 |
Total Medicare Allowed Amount |
45764.76 |
Total Medicare Payment Amount |
35644.71 |
Total Medicare Standardized Payment Amount |
34094.74 |
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 |
19 |
Number Of Medical Services |
307 |
Number Of Medicare Beneficiaries With Medical Services |
270 |
Total Medical Submitted Charge Amount |
169001 |
Total Medical Medicare Allowed Amount |
45764.76 |
Total Medical Medicare Payment Amount |
35644.71 |
Total Medical Medicare Standardized Payment Amount |
34094.74 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
171 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
115 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
138 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.4241 |