National Provider Identifier [NPI]: |
1407951189 |
Last Name Of The Provider |
HARDY |
First Name Of The Provider |
SAMUEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3838 SAN DIMAS ST |
Street Address 2 Of The Provider |
SUITE B-100 |
City Of The Provider |
BAKERSFIELD |
Zip Code Of The Provider |
933012284 |
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 |
34 |
Number Of Services |
571 |
Number Of Medicare Beneficiaries |
289 |
Total Submitted Charge Amount |
183044 |
Total Medicare Allowed Amount |
50416.3 |
Total Medicare Payment Amount |
39289.3 |
Total Medicare Standardized Payment Amount |
38888.37 |
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 |
34 |
Number Of Medical Services |
571 |
Number Of Medicare Beneficiaries With Medical Services |
289 |
Total Medical Submitted Charge Amount |
183044 |
Total Medical Medicare Allowed Amount |
50416.3 |
Total Medical Medicare Payment Amount |
39289.3 |
Total Medical Medicare Standardized Payment Amount |
38888.37 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
180 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
76 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
160 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.2348 |