National Provider Identifier [NPI]: |
1992720015 |
Last Name Of The Provider |
FELLOWS |
First Name Of The Provider |
JASON |
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 |
7417 N CEDAR AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937203637 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
430 |
Number Of Medicare Beneficiaries |
305 |
Total Submitted Charge Amount |
422284.18 |
Total Medicare Allowed Amount |
93174.83 |
Total Medicare Payment Amount |
72710.33 |
Total Medicare Standardized Payment Amount |
72902.64 |
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 |
69 |
Number Of Medical Services |
430 |
Number Of Medicare Beneficiaries With Medical Services |
305 |
Total Medical Submitted Charge Amount |
422284.18 |
Total Medical Medicare Allowed Amount |
93174.83 |
Total Medical Medicare Payment Amount |
72710.33 |
Total Medical Medicare Standardized Payment Amount |
72902.64 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
220 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
242 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5516 |