National Provider Identifier [NPI]: |
1235120767 |
Last Name Of The Provider |
ERIKSEN |
First Name Of The Provider |
LEIF |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2333 BUCHANAN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN FRANCISCO |
Zip Code Of The Provider |
941151925 |
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 |
21 |
Number Of Services |
745 |
Number Of Medicare Beneficiaries |
636 |
Total Submitted Charge Amount |
291231 |
Total Medicare Allowed Amount |
104734.24 |
Total Medicare Payment Amount |
78345.67 |
Total Medicare Standardized Payment Amount |
74008.35 |
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 |
21 |
Number Of Medical Services |
745 |
Number Of Medicare Beneficiaries With Medical Services |
636 |
Total Medical Submitted Charge Amount |
291231 |
Total Medical Medicare Allowed Amount |
104734.24 |
Total Medical Medicare Payment Amount |
78345.67 |
Total Medical Medicare Standardized Payment Amount |
74008.35 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
150 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
170 |
Number Of Beneficiaries Age Greater 84 |
137 |
Number Of Female Beneficiaries |
354 |
Number Of Male Beneficiaries |
282 |
Number Of Non Hispanic White Beneficiaries |
270 |
Number Of Black or African American Beneficiaries |
50 |
Number Of AsianPacific Islander Beneficiaries |
184 |
Number Of Hispanic Beneficiaries |
111 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
284 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
352 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.1437 |