National Provider Identifier [NPI]: |
1992786347 |
Last Name Of The Provider |
SCOTT |
First Name Of The Provider |
DIANE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15611 POMERADO RD |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
POWAY |
Zip Code Of The Provider |
920642437 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
3478 |
Number Of Medicare Beneficiaries |
1351 |
Total Submitted Charge Amount |
368249 |
Total Medicare Allowed Amount |
238646.94 |
Total Medicare Payment Amount |
166856.16 |
Total Medicare Standardized Payment Amount |
139545.83 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
563 |
Number Of Beneficiaries Age 75 to 84 |
476 |
Number Of Beneficiaries Age Greater 84 |
292 |
Number Of Female Beneficiaries |
752 |
Number Of Male Beneficiaries |
599 |
Number Of Non Hispanic White Beneficiaries |
1303 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
1323 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0814 |