National Provider Identifier [NPI]: |
1326028853 |
Last Name Of The Provider |
NEWSOM |
First Name Of The Provider |
ELIZABETH |
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 |
2911 CHANTICLEER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA CRUZ |
Zip Code Of The Provider |
950651815 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
3535 |
Number Of Medicare Beneficiaries |
606 |
Total Submitted Charge Amount |
1039251.3 |
Total Medicare Allowed Amount |
256568.1 |
Total Medicare Payment Amount |
193451.98 |
Total Medicare Standardized Payment Amount |
187000.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
377 |
Number Of Medicare Beneficiaries With Drug Services |
45 |
Total Drug Submitted ChargeAmount |
59457 |
Total Drug Medicare AllowedAmount |
19624.7 |
Total Drug Medicare PaymentAmount |
14923.78 |
Total Drug Medicare Standardized Payment Amount |
14923.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
86 |
Number Of Medical Services |
3158 |
Number Of Medicare Beneficiaries With Medical Services |
606 |
Total Medical Submitted Charge Amount |
979794.3 |
Total Medical Medicare Allowed Amount |
236943.4 |
Total Medical Medicare Payment Amount |
178528.2 |
Total Medical Medicare Standardized Payment Amount |
172076.81 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
238 |
Number Of Beneficiaries Age 75 to 84 |
196 |
Number Of Beneficiaries Age Greater 84 |
113 |
Number Of Female Beneficiaries |
448 |
Number Of Male Beneficiaries |
158 |
Number Of Non Hispanic White Beneficiaries |
522 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
512 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1666 |