National Provider Identifier [NPI]: |
1548202740 |
Last Name Of The Provider |
LAI |
First Name Of The Provider |
ANNIE |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2125 OAK GROVE RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
WALNUT CREEK |
Zip Code Of The Provider |
945982536 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
161 |
Number Of Services |
11492 |
Number Of Medicare Beneficiaries |
2591 |
Total Submitted Charge Amount |
1289838 |
Total Medicare Allowed Amount |
244176.48 |
Total Medicare Payment Amount |
188427.11 |
Total Medicare Standardized Payment Amount |
166573.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
7805 |
Number Of Medicare Beneficiaries With Drug Services |
98 |
Total Drug Submitted ChargeAmount |
9143 |
Total Drug Medicare AllowedAmount |
2747.54 |
Total Drug Medicare PaymentAmount |
2133.63 |
Total Drug Medicare Standardized Payment Amount |
2133.63 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
157 |
Number Of Medical Services |
3687 |
Number Of Medicare Beneficiaries With Medical Services |
2590 |
Total Medical Submitted Charge Amount |
1280695 |
Total Medical Medicare Allowed Amount |
241428.94 |
Total Medical Medicare Payment Amount |
186293.48 |
Total Medical Medicare Standardized Payment Amount |
164440.13 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
457 |
Number Of Beneficiaries Age 65 to 74 |
971 |
Number Of Beneficiaries Age 75 to 84 |
649 |
Number Of Beneficiaries Age Greater 84 |
514 |
Number Of Female Beneficiaries |
1568 |
Number Of Male Beneficiaries |
1023 |
Number Of Non Hispanic White Beneficiaries |
1383 |
Number Of Black or African American Beneficiaries |
610 |
Number Of AsianPacific Islander Beneficiaries |
295 |
Number Of Hispanic Beneficiaries |
230 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1632 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
959 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.8589 |