National Provider Identifier [NPI]: |
1902051899 |
Last Name Of The Provider |
KREVITZ |
First Name Of The Provider |
SHARI |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10666 N TORREY PINES RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LA JOLLA |
Zip Code Of The Provider |
920371027 |
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 |
12 |
Number Of Services |
3137 |
Number Of Medicare Beneficiaries |
283 |
Total Submitted Charge Amount |
674132 |
Total Medicare Allowed Amount |
358477.54 |
Total Medicare Payment Amount |
280402.4 |
Total Medicare Standardized Payment Amount |
267898.39 |
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 |
12 |
Number Of Medical Services |
3137 |
Number Of Medicare Beneficiaries With Medical Services |
283 |
Total Medical Submitted Charge Amount |
674132 |
Total Medical Medicare Allowed Amount |
358477.54 |
Total Medical Medicare Payment Amount |
280402.4 |
Total Medical Medicare Standardized Payment Amount |
267898.39 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
139 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
26 |
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
205 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
3.2252 |