National Provider Identifier [NPI]: |
1356413066 |
Last Name Of The Provider |
BRAININ-MATTOS |
First Name Of The Provider |
JOSUE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3315 WATT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958213600 |
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 |
88 |
Number Of Services |
582 |
Number Of Medicare Beneficiaries |
393 |
Total Submitted Charge Amount |
438985 |
Total Medicare Allowed Amount |
108537.19 |
Total Medicare Payment Amount |
82428.15 |
Total Medicare Standardized Payment Amount |
80406.39 |
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 |
88 |
Number Of Medical Services |
582 |
Number Of Medicare Beneficiaries With Medical Services |
393 |
Total Medical Submitted Charge Amount |
438985 |
Total Medical Medicare Allowed Amount |
108537.19 |
Total Medical Medicare Payment Amount |
82428.15 |
Total Medical Medicare Standardized Payment Amount |
80406.39 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
205 |
Number Of Male Beneficiaries |
188 |
Number Of Non Hispanic White Beneficiaries |
332 |
Number Of Black or African American Beneficiaries |
45 |
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 |
331 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.766 |