National Provider Identifier [NPI]: |
1245337039 |
Last Name Of The Provider |
HARWOOD |
First Name Of The Provider |
DYLAN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
PH.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10801 NATIONAL BLVD |
Street Address 2 Of The Provider |
SUITE 611 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900644170 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
1358 |
Number Of Medicare Beneficiaries |
180 |
Total Submitted Charge Amount |
392050 |
Total Medicare Allowed Amount |
139095.57 |
Total Medicare Payment Amount |
108934.09 |
Total Medicare Standardized Payment Amount |
107208.76 |
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 |
5 |
Number Of Medical Services |
1358 |
Number Of Medicare Beneficiaries With Medical Services |
180 |
Total Medical Submitted Charge Amount |
392050 |
Total Medical Medicare Allowed Amount |
139095.57 |
Total Medical Medicare Payment Amount |
108934.09 |
Total Medical Medicare Standardized Payment Amount |
107208.76 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
81 |
Number Of Non Hispanic White Beneficiaries |
46 |
Number Of Black or African American Beneficiaries |
114 |
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 |
20 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
160 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
56 |
Percent Of With Depression |
62 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
56 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
3.6016 |