National Provider Identifier [NPI]: |
1255362489 |
Last Name Of The Provider |
HURST |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 E CHURCH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA MARIA |
Zip Code Of The Provider |
934545906 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
799 |
Number Of Medicare Beneficiaries |
572 |
Total Submitted Charge Amount |
349292 |
Total Medicare Allowed Amount |
84041.89 |
Total Medicare Payment Amount |
63918.39 |
Total Medicare Standardized Payment Amount |
63265.09 |
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 |
23 |
Number Of Medical Services |
799 |
Number Of Medicare Beneficiaries With Medical Services |
572 |
Total Medical Submitted Charge Amount |
349292 |
Total Medical Medicare Allowed Amount |
84041.89 |
Total Medical Medicare Payment Amount |
63918.39 |
Total Medical Medicare Standardized Payment Amount |
63265.09 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
138 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
158 |
Number Of Beneficiaries Age Greater 84 |
123 |
Number Of Female Beneficiaries |
321 |
Number Of Male Beneficiaries |
251 |
Number Of Non Hispanic White Beneficiaries |
354 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
185 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
340 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
232 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6705 |