National Provider Identifier [NPI]: |
1942495619 |
Last Name Of The Provider |
MORN |
First Name Of The Provider |
CASSANDRA |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9909 MIRA MESA BLVD STE 200 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921311061 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
834 |
Number Of Medicare Beneficiaries |
222 |
Total Submitted Charge Amount |
104647 |
Total Medicare Allowed Amount |
46960.45 |
Total Medicare Payment Amount |
33367.71 |
Total Medicare Standardized Payment Amount |
32417.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
116 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
2808 |
Total Drug Medicare AllowedAmount |
1594.03 |
Total Drug Medicare PaymentAmount |
1552.14 |
Total Drug Medicare Standardized Payment Amount |
1552.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
718 |
Number Of Medicare Beneficiaries With Medical Services |
222 |
Total Medical Submitted Charge Amount |
101839 |
Total Medical Medicare Allowed Amount |
45366.42 |
Total Medical Medicare Payment Amount |
31815.57 |
Total Medical Medicare Standardized Payment Amount |
30865.77 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
136 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
43 |
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
161 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0636 |