National Provider Identifier [NPI]: |
1366582264 |
Last Name Of The Provider |
LOUDERMILK |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6501 COYLE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CARMICHAEL |
Zip Code Of The Provider |
956080306 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
719 |
Number Of Medicare Beneficiaries |
423 |
Total Submitted Charge Amount |
255483 |
Total Medicare Allowed Amount |
73782.94 |
Total Medicare Payment Amount |
57030.59 |
Total Medicare Standardized Payment Amount |
56444.97 |
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 |
23 |
Number Of Medical Services |
719 |
Number Of Medicare Beneficiaries With Medical Services |
423 |
Total Medical Submitted Charge Amount |
255483 |
Total Medical Medicare Allowed Amount |
73782.94 |
Total Medical Medicare Payment Amount |
57030.59 |
Total Medical Medicare Standardized Payment Amount |
56444.97 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
119 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
184 |
Number Of Non Hispanic White Beneficiaries |
219 |
Number Of Black or African American Beneficiaries |
83 |
Number Of AsianPacific Islander Beneficiaries |
53 |
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
192 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
231 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.0764 |