National Provider Identifier [NPI]: |
1396759981 |
Last Name Of The Provider |
CARROLL |
First Name Of The Provider |
BRENDAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8670 WILSHIRE BLVD |
Street Address 2 Of The Provider |
STE 203 |
City Of The Provider |
BEVERLY HILLS |
Zip Code Of The Provider |
902112924 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
672 |
Number Of Medicare Beneficiaries |
320 |
Total Submitted Charge Amount |
4336950.62 |
Total Medicare Allowed Amount |
215539 |
Total Medicare Payment Amount |
168383.73 |
Total Medicare Standardized Payment Amount |
163356.83 |
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 |
84 |
Number Of Medical Services |
672 |
Number Of Medicare Beneficiaries With Medical Services |
320 |
Total Medical Submitted Charge Amount |
4336950.62 |
Total Medical Medicare Allowed Amount |
215539 |
Total Medical Medicare Payment Amount |
168383.73 |
Total Medical Medicare Standardized Payment Amount |
163356.83 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
185 |
Number Of Non Hispanic White Beneficiaries |
251 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
242 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.2384 |