National Provider Identifier [NPI]: |
1659464485 |
Last Name Of The Provider |
RANGEL |
First Name Of The Provider |
DECIO |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2001 SANTA MONICA BLVD |
Street Address 2 Of The Provider |
#780W |
City Of The Provider |
SANTA MONICA |
Zip Code Of The Provider |
90404 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Surgical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
933 |
Number Of Medicare Beneficiaries |
349 |
Total Submitted Charge Amount |
479810 |
Total Medicare Allowed Amount |
198010.46 |
Total Medicare Payment Amount |
153176.93 |
Total Medicare Standardized Payment Amount |
146630.2 |
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 |
75 |
Number Of Medical Services |
933 |
Number Of Medicare Beneficiaries With Medical Services |
349 |
Total Medical Submitted Charge Amount |
479810 |
Total Medical Medicare Allowed Amount |
198010.46 |
Total Medical Medicare Payment Amount |
153176.93 |
Total Medical Medicare Standardized Payment Amount |
146630.2 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
252 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
307 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
321 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
46 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2116 |