National Provider Identifier [NPI]: |
1831147024 |
Last Name Of The Provider |
SAUNDERS |
First Name Of The Provider |
MARVOUS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2621 SOUTH BRISTOL |
Street Address 2 Of The Provider |
#102 |
City Of The Provider |
SANTA ANA |
Zip Code Of The Provider |
92704 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1123 |
Number Of Medicare Beneficiaries |
593 |
Total Submitted Charge Amount |
170206.63 |
Total Medicare Allowed Amount |
104865 |
Total Medicare Payment Amount |
80218.2 |
Total Medicare Standardized Payment Amount |
77903.59 |
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 |
29 |
Number Of Medical Services |
1123 |
Number Of Medicare Beneficiaries With Medical Services |
593 |
Total Medical Submitted Charge Amount |
170206.63 |
Total Medical Medicare Allowed Amount |
104865 |
Total Medical Medicare Payment Amount |
80218.2 |
Total Medical Medicare Standardized Payment Amount |
77903.59 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
135 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
162 |
Number Of Beneficiaries Age Greater 84 |
180 |
Number Of Female Beneficiaries |
332 |
Number Of Male Beneficiaries |
261 |
Number Of Non Hispanic White Beneficiaries |
348 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
75 |
Number Of Hispanic Beneficiaries |
139 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
98 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
495 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
51 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.7705 |