National Provider Identifier [NPI]: |
1346308798 |
Last Name Of The Provider |
TOMSKY |
First Name Of The Provider |
JANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1520 KIRKER PASS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLAYTON |
Zip Code Of The Provider |
945171096 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
514 |
Number Of Medicare Beneficiaries |
254 |
Total Submitted Charge Amount |
78643 |
Total Medicare Allowed Amount |
56513.04 |
Total Medicare Payment Amount |
40881.98 |
Total Medicare Standardized Payment Amount |
36512.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
440 |
Total Drug Medicare AllowedAmount |
335.09 |
Total Drug Medicare PaymentAmount |
328.31 |
Total Drug Medicare Standardized Payment Amount |
328.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
499 |
Number Of Medicare Beneficiaries With Medical Services |
254 |
Total Medical Submitted Charge Amount |
78203 |
Total Medical Medicare Allowed Amount |
56177.95 |
Total Medical Medicare Payment Amount |
40553.67 |
Total Medical Medicare Standardized Payment Amount |
36184.66 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
217 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
223 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1089 |