National Provider Identifier [NPI]: |
1922064377 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
WADE |
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 |
505 PARNASSUS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN FRANCISCO |
Zip Code Of The Provider |
941432204 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
388 |
Number Of Medicare Beneficiaries |
269 |
Total Submitted Charge Amount |
176048 |
Total Medicare Allowed Amount |
37119.01 |
Total Medicare Payment Amount |
28169.67 |
Total Medicare Standardized Payment Amount |
24717.72 |
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 |
19 |
Number Of Medical Services |
388 |
Number Of Medicare Beneficiaries With Medical Services |
269 |
Total Medical Submitted Charge Amount |
176048 |
Total Medical Medicare Allowed Amount |
37119.01 |
Total Medical Medicare Payment Amount |
28169.67 |
Total Medical Medicare Standardized Payment Amount |
24717.72 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
180 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
41 |
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 |
177 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
50 |
Average HCC Risk Score Of Beneficiaries |
1.6081 |