National Provider Identifier [NPI]: |
1659531127 |
Last Name Of The Provider |
SPURLOCK |
First Name Of The Provider |
JENNIFER |
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 |
354 SANTA FE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ENCINITAS |
Zip Code Of The Provider |
920245142 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
478 |
Number Of Medicare Beneficiaries |
266 |
Total Submitted Charge Amount |
171821.02 |
Total Medicare Allowed Amount |
63128.39 |
Total Medicare Payment Amount |
49083.1 |
Total Medicare Standardized Payment Amount |
48309.06 |
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 |
15 |
Number Of Medical Services |
478 |
Number Of Medicare Beneficiaries With Medical Services |
266 |
Total Medical Submitted Charge Amount |
171821.02 |
Total Medical Medicare Allowed Amount |
63128.39 |
Total Medical Medicare Payment Amount |
49083.1 |
Total Medical Medicare Standardized Payment Amount |
48309.06 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
224 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
233 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
1.8326 |