National Provider Identifier [NPI]: |
1427095439 |
Last Name Of The Provider |
QUIGLEY |
First Name Of The Provider |
MALACHI |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9339 GENESEE AVE |
Street Address 2 Of The Provider |
STE 220 |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921212121 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
621 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
45778 |
Total Medicare Allowed Amount |
23427.48 |
Total Medicare Payment Amount |
17554.2 |
Total Medicare Standardized Payment Amount |
17033.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
187 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
5243 |
Total Drug Medicare AllowedAmount |
776.43 |
Total Drug Medicare PaymentAmount |
534.45 |
Total Drug Medicare Standardized Payment Amount |
534.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
434 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
40535 |
Total Medical Medicare Allowed Amount |
22651.05 |
Total Medical Medicare Payment Amount |
17019.75 |
Total Medical Medicare Standardized Payment Amount |
16498.69 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
17 |
Number Of Non Hispanic White Beneficiaries |
117 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
27 |
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
35 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6048 |