National Provider Identifier [NPI]: |
1992942825 |
Last Name Of The Provider |
SLOCUM |
First Name Of The Provider |
SVETLANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
813 15TH ST |
Street Address 2 Of The Provider |
UNIT F |
City Of The Provider |
SANTA MONICA |
Zip Code Of The Provider |
904031824 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
145 |
Number Of Medicare Beneficiaries |
133 |
Total Submitted Charge Amount |
181416 |
Total Medicare Allowed Amount |
37230.57 |
Total Medicare Payment Amount |
29081.45 |
Total Medicare Standardized Payment Amount |
28289.21 |
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 |
44 |
Number Of Medical Services |
145 |
Number Of Medicare Beneficiaries With Medical Services |
133 |
Total Medical Submitted Charge Amount |
181416 |
Total Medical Medicare Allowed Amount |
37230.57 |
Total Medical Medicare Payment Amount |
29081.45 |
Total Medical Medicare Standardized Payment Amount |
28289.21 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
79 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.3346 |