National Provider Identifier [NPI]: |
1225088537 |
Last Name Of The Provider |
CLAVIJO |
First Name Of The Provider |
LEONARDO |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1520 SAN PABLO ST |
Street Address 2 Of The Provider |
SUITE 1000 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900335310 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
87 |
Number Of Services |
1416 |
Number Of Medicare Beneficiaries |
766 |
Total Submitted Charge Amount |
462434 |
Total Medicare Allowed Amount |
125199.28 |
Total Medicare Payment Amount |
95286.76 |
Total Medicare Standardized Payment Amount |
91085.52 |
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 |
87 |
Number Of Medical Services |
1416 |
Number Of Medicare Beneficiaries With Medical Services |
766 |
Total Medical Submitted Charge Amount |
462434 |
Total Medical Medicare Allowed Amount |
125199.28 |
Total Medical Medicare Payment Amount |
95286.76 |
Total Medical Medicare Standardized Payment Amount |
91085.52 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
192 |
Number Of Beneficiaries Age 65 to 74 |
269 |
Number Of Beneficiaries Age 75 to 84 |
236 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
331 |
Number Of Male Beneficiaries |
435 |
Number Of Non Hispanic White Beneficiaries |
271 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
87 |
Number Of Hispanic Beneficiaries |
355 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
364 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
402 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
71 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.9851 |