National Provider Identifier [NPI]: |
1992720379 |
Last Name Of The Provider |
AMOS |
First Name Of The Provider |
EDWIN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2021 SANTA MONICA BLVD |
Street Address 2 Of The Provider |
SUITE 525E |
City Of The Provider |
SANTA MONICA |
Zip Code Of The Provider |
904042208 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
336 |
Number Of Medicare Beneficiaries |
137 |
Total Submitted Charge Amount |
71105 |
Total Medicare Allowed Amount |
43313.23 |
Total Medicare Payment Amount |
32260.46 |
Total Medicare Standardized Payment Amount |
29694.08 |
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 |
13 |
Number Of Medical Services |
336 |
Number Of Medicare Beneficiaries With Medical Services |
137 |
Total Medical Submitted Charge Amount |
71105 |
Total Medical Medicare Allowed Amount |
43313.23 |
Total Medical Medicare Payment Amount |
32260.46 |
Total Medical Medicare Standardized Payment Amount |
29694.08 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
78 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
122 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
15 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.2577 |