National Provider Identifier [NPI]: |
1306807862 |
Last Name Of The Provider |
BERN |
First Name Of The Provider |
SAMUEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1280 S VICTORIA AVE |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
VENTURA |
Zip Code Of The Provider |
930036555 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Plastic and Reconstructive Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
490 |
Number Of Medicare Beneficiaries |
235 |
Total Submitted Charge Amount |
185197.24 |
Total Medicare Allowed Amount |
169601.6 |
Total Medicare Payment Amount |
131951.82 |
Total Medicare Standardized Payment Amount |
123989.89 |
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 |
79 |
Number Of Medical Services |
490 |
Number Of Medicare Beneficiaries With Medical Services |
235 |
Total Medical Submitted Charge Amount |
185197.24 |
Total Medical Medicare Allowed Amount |
169601.6 |
Total Medical Medicare Payment Amount |
131951.82 |
Total Medical Medicare Standardized Payment Amount |
123989.89 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
213 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
208 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1958 |