National Provider Identifier [NPI]: |
1376792572 |
Last Name Of The Provider |
BHASKER |
First Name Of The Provider |
KALA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
145 THUNDER DR 1ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
VISTA |
Zip Code Of The Provider |
920836010 |
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 |
70 |
Number Of Services |
542 |
Number Of Medicare Beneficiaries |
130 |
Total Submitted Charge Amount |
52987 |
Total Medicare Allowed Amount |
35801.67 |
Total Medicare Payment Amount |
25905.95 |
Total Medicare Standardized Payment Amount |
24832.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
1567 |
Total Drug Medicare AllowedAmount |
976.63 |
Total Drug Medicare PaymentAmount |
955 |
Total Drug Medicare Standardized Payment Amount |
955 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
64 |
Number Of Medical Services |
517 |
Number Of Medicare Beneficiaries With Medical Services |
130 |
Total Medical Submitted Charge Amount |
51420 |
Total Medical Medicare Allowed Amount |
34825.04 |
Total Medical Medicare Payment Amount |
24950.95 |
Total Medical Medicare Standardized Payment Amount |
23877.74 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
94 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
115 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0305 |