National Provider Identifier [NPI]: |
1962433839 |
Last Name Of The Provider |
EKKENS |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1040 MANGROVE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICO |
Zip Code Of The Provider |
959263509 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
143 |
Number Of Services |
7825 |
Number Of Medicare Beneficiaries |
427 |
Total Submitted Charge Amount |
439453.74 |
Total Medicare Allowed Amount |
312399.7 |
Total Medicare Payment Amount |
237432.33 |
Total Medicare Standardized Payment Amount |
233852.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
20 |
Number Of Drug Services |
1543 |
Number Of Medicare Beneficiaries With Drug Services |
215 |
Total Drug Submitted ChargeAmount |
48227.74 |
Total Drug Medicare AllowedAmount |
33135.44 |
Total Drug Medicare PaymentAmount |
29656.44 |
Total Drug Medicare Standardized Payment Amount |
29656.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
123 |
Number Of Medical Services |
6282 |
Number Of Medicare Beneficiaries With Medical Services |
427 |
Total Medical Submitted Charge Amount |
391226 |
Total Medical Medicare Allowed Amount |
279264.26 |
Total Medical Medicare Payment Amount |
207775.89 |
Total Medical Medicare Standardized Payment Amount |
204196.08 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
188 |
Number Of Non Hispanic White Beneficiaries |
399 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
346 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1445 |