National Provider Identifier [NPI]: |
1164449849 |
Last Name Of The Provider |
RUNYON |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11370 ANDERSON ST |
Street Address 2 Of The Provider |
STE 3150 |
City Of The Provider |
LOMA LINDA |
Zip Code Of The Provider |
923543450 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
446 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
121503 |
Total Medicare Allowed Amount |
41099.41 |
Total Medicare Payment Amount |
30712.86 |
Total Medicare Standardized Payment Amount |
29306.34 |
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 |
13 |
Number Of Medical Services |
446 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
121503 |
Total Medical Medicare Allowed Amount |
41099.41 |
Total Medical Medicare Payment Amount |
30712.86 |
Total Medical Medicare Standardized Payment Amount |
29306.34 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
67 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
69 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.4247 |