National Provider Identifier [NPI]: |
1538200852 |
Last Name Of The Provider |
USMAN |
First Name Of The Provider |
ROMANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 HYDE ST |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
SAN FRANCISCO |
Zip Code Of The Provider |
941094806 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
718 |
Number Of Medicare Beneficiaries |
114 |
Total Submitted Charge Amount |
104473 |
Total Medicare Allowed Amount |
72275.35 |
Total Medicare Payment Amount |
53486.84 |
Total Medicare Standardized Payment Amount |
46879.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
34 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
1135 |
Total Drug Medicare AllowedAmount |
775.28 |
Total Drug Medicare PaymentAmount |
757.08 |
Total Drug Medicare Standardized Payment Amount |
757.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
684 |
Number Of Medicare Beneficiaries With Medical Services |
114 |
Total Medical Submitted Charge Amount |
103338 |
Total Medical Medicare Allowed Amount |
71500.07 |
Total Medical Medicare Payment Amount |
52729.76 |
Total Medical Medicare Standardized Payment Amount |
46122.57 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
82 |
Number Of Male Beneficiaries |
32 |
Number Of Non Hispanic White Beneficiaries |
70 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
59 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
10 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
29 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1235 |