National Provider Identifier [NPI]: |
1831195221 |
Last Name Of The Provider |
SAENZ |
First Name Of The Provider |
ROY |
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 |
931 BUENA VISTA ST |
Street Address 2 Of The Provider |
STE 205 |
City Of The Provider |
DUARTE |
Zip Code Of The Provider |
910101713 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
461 |
Number Of Medicare Beneficiaries |
119 |
Total Submitted Charge Amount |
61092 |
Total Medicare Allowed Amount |
50310.77 |
Total Medicare Payment Amount |
34346.4 |
Total Medicare Standardized Payment Amount |
32040.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
53 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
2094 |
Total Drug Medicare AllowedAmount |
612.09 |
Total Drug Medicare PaymentAmount |
598.21 |
Total Drug Medicare Standardized Payment Amount |
598.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
408 |
Number Of Medicare Beneficiaries With Medical Services |
119 |
Total Medical Submitted Charge Amount |
58998 |
Total Medical Medicare Allowed Amount |
49698.68 |
Total Medical Medicare Payment Amount |
33748.19 |
Total Medical Medicare Standardized Payment Amount |
31442.26 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
58 |
Number Of Male Beneficiaries |
61 |
Number Of Non Hispanic White Beneficiaries |
46 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
57 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
75 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3987 |