National Provider Identifier [NPI]: |
1154408763 |
Last Name Of The Provider |
HUMBERSON |
First Name Of The Provider |
CORA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10666 N TORREY PINES RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LA JOLLA |
Zip Code Of The Provider |
920371027 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
3660 |
Number Of Medicare Beneficiaries |
1817 |
Total Submitted Charge Amount |
349160.77 |
Total Medicare Allowed Amount |
138945.12 |
Total Medicare Payment Amount |
106813.61 |
Total Medicare Standardized Payment Amount |
81987.56 |
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 |
11 |
Number Of Medical Services |
3660 |
Number Of Medicare Beneficiaries With Medical Services |
1817 |
Total Medical Submitted Charge Amount |
349160.77 |
Total Medical Medicare Allowed Amount |
138945.12 |
Total Medical Medicare Payment Amount |
106813.61 |
Total Medical Medicare Standardized Payment Amount |
81987.56 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
800 |
Number Of Beneficiaries Age 75 to 84 |
607 |
Number Of Beneficiaries Age Greater 84 |
351 |
Number Of Female Beneficiaries |
795 |
Number Of Male Beneficiaries |
1022 |
Number Of Non Hispanic White Beneficiaries |
1730 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
32 |
Number Of Beneficiaries With Medicare Only Entitlement |
1742 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1149 |