National Provider Identifier [NPI]: |
1336158211 |
Last Name Of The Provider |
NOVAK |
First Name Of The Provider |
DENNIS |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
320 SUPERIOR AVE |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
NEWPORT BEACH |
Zip Code Of The Provider |
926632741 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
5006 |
Number Of Medicare Beneficiaries |
422 |
Total Submitted Charge Amount |
454482 |
Total Medicare Allowed Amount |
300101.33 |
Total Medicare Payment Amount |
231069.24 |
Total Medicare Standardized Payment Amount |
206119.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
1279 |
Number Of Medicare Beneficiaries With Drug Services |
257 |
Total Drug Submitted ChargeAmount |
13333 |
Total Drug Medicare AllowedAmount |
10658.54 |
Total Drug Medicare PaymentAmount |
9251.57 |
Total Drug Medicare Standardized Payment Amount |
9251.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
3727 |
Number Of Medicare Beneficiaries With Medical Services |
422 |
Total Medical Submitted Charge Amount |
441149 |
Total Medical Medicare Allowed Amount |
289442.79 |
Total Medical Medicare Payment Amount |
221817.67 |
Total Medical Medicare Standardized Payment Amount |
196868.3 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
157 |
Number Of Beneficiaries Age 75 to 84 |
163 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
256 |
Number Of Male Beneficiaries |
166 |
Number Of Non Hispanic White Beneficiaries |
395 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
11 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
40 |
Percent Of With Cancer |
27 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.6673 |