National Provider Identifier [NPI]: |
1962583872 |
Last Name Of The Provider |
KRISTENSEN |
First Name Of The Provider |
TORBEN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 E EL CAMINO REAL |
Street Address 2 Of The Provider |
|
City Of The Provider |
MOUNTAIN VIEW |
Zip Code Of The Provider |
940402833 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
170 |
Number Of Services |
32723 |
Number Of Medicare Beneficiaries |
2427 |
Total Submitted Charge Amount |
2071944.5 |
Total Medicare Allowed Amount |
523085.93 |
Total Medicare Payment Amount |
405977.71 |
Total Medicare Standardized Payment Amount |
327328.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
29196 |
Number Of Medicare Beneficiaries With Drug Services |
289 |
Total Drug Submitted ChargeAmount |
39553 |
Total Drug Medicare AllowedAmount |
8926.83 |
Total Drug Medicare PaymentAmount |
6985.54 |
Total Drug Medicare Standardized Payment Amount |
6985.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
166 |
Number Of Medical Services |
3527 |
Number Of Medicare Beneficiaries With Medical Services |
2427 |
Total Medical Submitted Charge Amount |
2032391.5 |
Total Medical Medicare Allowed Amount |
514159.1 |
Total Medical Medicare Payment Amount |
398992.17 |
Total Medical Medicare Standardized Payment Amount |
320342.68 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
174 |
Number Of Beneficiaries Age 65 to 74 |
1136 |
Number Of Beneficiaries Age 75 to 84 |
773 |
Number Of Beneficiaries Age Greater 84 |
344 |
Number Of Female Beneficiaries |
1624 |
Number Of Male Beneficiaries |
803 |
Number Of Non Hispanic White Beneficiaries |
1646 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
459 |
Number Of Hispanic Beneficiaries |
176 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
99 |
Number Of Beneficiaries With Medicare Only Entitlement |
1909 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
518 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0285 |