National Provider Identifier [NPI]: |
1053351346 |
Last Name Of The Provider |
KALAW |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
501 S BUENA VISTA ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BURBANK |
Zip Code Of The Provider |
915054809 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
238 |
Number Of Medicare Beneficiaries |
167 |
Total Submitted Charge Amount |
81725 |
Total Medicare Allowed Amount |
16607.3 |
Total Medicare Payment Amount |
12149.08 |
Total Medicare Standardized Payment Amount |
13771.22 |
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 |
38 |
Number Of Medical Services |
238 |
Number Of Medicare Beneficiaries With Medical Services |
167 |
Total Medical Submitted Charge Amount |
81725 |
Total Medical Medicare Allowed Amount |
16607.3 |
Total Medical Medicare Payment Amount |
12149.08 |
Total Medical Medicare Standardized Payment Amount |
13771.22 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
104 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
74 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.629 |