National Provider Identifier [NPI]: |
1386754216 |
Last Name Of The Provider |
BEARIE |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2101 N WATERMAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN BERNARDINO |
Zip Code Of The Provider |
924044836 |
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 |
104 |
Number Of Services |
3816 |
Number Of Medicare Beneficiaries |
558 |
Total Submitted Charge Amount |
422546.85 |
Total Medicare Allowed Amount |
215266.74 |
Total Medicare Payment Amount |
162085.36 |
Total Medicare Standardized Payment Amount |
161033.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
17 |
Number Of Drug Services |
751 |
Number Of Medicare Beneficiaries With Drug Services |
141 |
Total Drug Submitted ChargeAmount |
1603.09 |
Total Drug Medicare AllowedAmount |
680.08 |
Total Drug Medicare PaymentAmount |
539.86 |
Total Drug Medicare Standardized Payment Amount |
539.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
87 |
Number Of Medical Services |
3065 |
Number Of Medicare Beneficiaries With Medical Services |
558 |
Total Medical Submitted Charge Amount |
420943.76 |
Total Medical Medicare Allowed Amount |
214586.66 |
Total Medical Medicare Payment Amount |
161545.5 |
Total Medical Medicare Standardized Payment Amount |
160493.53 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
199 |
Number Of Beneficiaries Age 65 to 74 |
195 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
335 |
Number Of Male Beneficiaries |
223 |
Number Of Non Hispanic White Beneficiaries |
352 |
Number Of Black or African American Beneficiaries |
39 |
Number Of AsianPacific Islander Beneficiaries |
19 |
Number Of Hispanic Beneficiaries |
136 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
266 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
292 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.7982 |