National Provider Identifier [NPI]: |
1609890813 |
Last Name Of The Provider |
FERBER |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
130 CEDAR RD # 340 |
Street Address 2 Of The Provider |
|
City Of The Provider |
VISTA |
Zip Code Of The Provider |
920835102 |
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 |
45 |
Number Of Services |
567 |
Number Of Medicare Beneficiaries |
117 |
Total Submitted Charge Amount |
75580 |
Total Medicare Allowed Amount |
37976.27 |
Total Medicare Payment Amount |
28031.6 |
Total Medicare Standardized Payment Amount |
26986.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
89 |
Number Of Medicare Beneficiaries With Drug Services |
51 |
Total Drug Submitted ChargeAmount |
6873 |
Total Drug Medicare AllowedAmount |
3489.86 |
Total Drug Medicare PaymentAmount |
3414.47 |
Total Drug Medicare Standardized Payment Amount |
3414.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
478 |
Number Of Medicare Beneficiaries With Medical Services |
117 |
Total Medical Submitted Charge Amount |
68707 |
Total Medical Medicare Allowed Amount |
34486.41 |
Total Medical Medicare Payment Amount |
24617.13 |
Total Medical Medicare Standardized Payment Amount |
23572.16 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
105 |
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 |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9607 |