National Provider Identifier [NPI]: |
1952418212 |
Last Name Of The Provider |
MARKLEY |
First Name Of The Provider |
KEITH |
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 |
1024 MANZANITA ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900293080 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
1054 |
Number Of Medicare Beneficiaries |
442 |
Total Submitted Charge Amount |
257150 |
Total Medicare Allowed Amount |
111423.74 |
Total Medicare Payment Amount |
86820.82 |
Total Medicare Standardized Payment Amount |
81640.8 |
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 |
4 |
Number Of Medical Services |
1054 |
Number Of Medicare Beneficiaries With Medical Services |
442 |
Total Medical Submitted Charge Amount |
257150 |
Total Medical Medicare Allowed Amount |
111423.74 |
Total Medical Medicare Payment Amount |
86820.82 |
Total Medical Medicare Standardized Payment Amount |
81640.8 |
Average Age Of Beneficiaries |
54 |
Number Of Beneficiaries Age Less65 |
332 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
273 |
Number Of Non Hispanic White Beneficiaries |
193 |
Number Of Black or African American Beneficiaries |
106 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
104 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
16 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
426 |
Percent Of With Atrial Fibrillation |
3 |
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
74 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
75 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
2.2464 |