National Provider Identifier [NPI]: |
1750383659 |
Last Name Of The Provider |
CARSON |
First Name Of The Provider |
STANLEY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4300 LONG BEACH BLVD |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
LONG BEACH |
Zip Code Of The Provider |
908072011 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
7107 |
Number Of Medicare Beneficiaries |
426 |
Total Submitted Charge Amount |
1787281 |
Total Medicare Allowed Amount |
984208.11 |
Total Medicare Payment Amount |
751816.38 |
Total Medicare Standardized Payment Amount |
728653.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
1714 |
Number Of Medicare Beneficiaries With Drug Services |
122 |
Total Drug Submitted ChargeAmount |
1195140 |
Total Drug Medicare AllowedAmount |
619452.24 |
Total Drug Medicare PaymentAmount |
480384.91 |
Total Drug Medicare Standardized Payment Amount |
480384.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
5393 |
Number Of Medicare Beneficiaries With Medical Services |
426 |
Total Medical Submitted Charge Amount |
592141 |
Total Medical Medicare Allowed Amount |
364755.87 |
Total Medical Medicare Payment Amount |
271431.47 |
Total Medical Medicare Standardized Payment Amount |
248268.84 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
114 |
Number Of Female Beneficiaries |
247 |
Number Of Male Beneficiaries |
179 |
Number Of Non Hispanic White Beneficiaries |
262 |
Number Of Black or African American Beneficiaries |
38 |
Number Of AsianPacific Islander Beneficiaries |
49 |
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
308 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.7085 |