National Provider Identifier [NPI]: |
1598723348 |
Last Name Of The Provider |
FOLIENTE |
First Name Of The Provider |
ROY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 SIERRA COLLEGE DR |
Street Address 2 Of The Provider |
STE.105 |
City Of The Provider |
GRASS VALLEY |
Zip Code Of The Provider |
959455082 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
1373 |
Number Of Medicare Beneficiaries |
624 |
Total Submitted Charge Amount |
774130 |
Total Medicare Allowed Amount |
223506.97 |
Total Medicare Payment Amount |
167213.44 |
Total Medicare Standardized Payment Amount |
164356.33 |
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 |
40 |
Number Of Medical Services |
1373 |
Number Of Medicare Beneficiaries With Medical Services |
624 |
Total Medical Submitted Charge Amount |
774130 |
Total Medical Medicare Allowed Amount |
223506.97 |
Total Medical Medicare Payment Amount |
167213.44 |
Total Medical Medicare Standardized Payment Amount |
164356.33 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
358 |
Number Of Beneficiaries Age 75 to 84 |
164 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
337 |
Number Of Male Beneficiaries |
287 |
Number Of Non Hispanic White Beneficiaries |
592 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
555 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9339 |