National Provider Identifier [NPI]: |
1306872585 |
Last Name Of The Provider |
BLOZE |
First Name Of The Provider |
ASTA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6815 NOBLE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
VAN NUYS |
Zip Code Of The Provider |
914053796 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
3287 |
Number Of Medicare Beneficiaries |
544 |
Total Submitted Charge Amount |
1018154 |
Total Medicare Allowed Amount |
273453.64 |
Total Medicare Payment Amount |
208766.71 |
Total Medicare Standardized Payment Amount |
181827.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
1071 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
23431 |
Total Drug Medicare AllowedAmount |
13137.08 |
Total Drug Medicare PaymentAmount |
10299.5 |
Total Drug Medicare Standardized Payment Amount |
10299.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
72 |
Number Of Medical Services |
2216 |
Number Of Medicare Beneficiaries With Medical Services |
544 |
Total Medical Submitted Charge Amount |
994723 |
Total Medical Medicare Allowed Amount |
260316.56 |
Total Medical Medicare Payment Amount |
198467.21 |
Total Medical Medicare Standardized Payment Amount |
171527.79 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
291 |
Number Of Beneficiaries Age 75 to 84 |
168 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
310 |
Number Of Male Beneficiaries |
234 |
Number Of Non Hispanic White Beneficiaries |
484 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
521 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9467 |