National Provider Identifier [NPI]: |
1487822516 |
Last Name Of The Provider |
GUERRERO |
First Name Of The Provider |
MARLON |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 DIVISADERO ST |
Street Address 2 Of The Provider |
MT. ZION HOSPITAL, 3RD FLOOR |
City Of The Provider |
SAN FRANCISCO |
Zip Code Of The Provider |
941153010 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
609 |
Number Of Medicare Beneficiaries |
241 |
Total Submitted Charge Amount |
356933.6 |
Total Medicare Allowed Amount |
94549.35 |
Total Medicare Payment Amount |
73123.75 |
Total Medicare Standardized Payment Amount |
73784.44 |
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 |
46 |
Number Of Medical Services |
609 |
Number Of Medicare Beneficiaries With Medical Services |
241 |
Total Medical Submitted Charge Amount |
356933.6 |
Total Medical Medicare Allowed Amount |
94549.35 |
Total Medical Medicare Payment Amount |
73123.75 |
Total Medical Medicare Standardized Payment Amount |
73784.44 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
200 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
213 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3511 |