National Provider Identifier [NPI]: |
1306867395 |
Last Name Of The Provider |
HLADIK |
First Name Of The Provider |
ANDREA |
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 |
39000 BOB HOPE DR |
Street Address 2 Of The Provider |
EMERGENCY DEPARTMENT |
City Of The Provider |
RANCHO MIRAGE |
Zip Code Of The Provider |
922703221 |
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 |
838 |
Number Of Medicare Beneficiaries |
769 |
Total Submitted Charge Amount |
661461.95 |
Total Medicare Allowed Amount |
133562.67 |
Total Medicare Payment Amount |
101214.35 |
Total Medicare Standardized Payment Amount |
100413.45 |
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 |
838 |
Number Of Medicare Beneficiaries With Medical Services |
769 |
Total Medical Submitted Charge Amount |
661461.95 |
Total Medical Medicare Allowed Amount |
133562.67 |
Total Medical Medicare Payment Amount |
101214.35 |
Total Medical Medicare Standardized Payment Amount |
100413.45 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
222 |
Number Of Beneficiaries Age 75 to 84 |
259 |
Number Of Beneficiaries Age Greater 84 |
194 |
Number Of Female Beneficiaries |
382 |
Number Of Male Beneficiaries |
387 |
Number Of Non Hispanic White Beneficiaries |
630 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
106 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
610 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
159 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9962 |