National Provider Identifier [NPI]: |
1235340563 |
Last Name Of The Provider |
SHARP |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 W ARBOR DR |
Street Address 2 Of The Provider |
UCSD MEDICAL CENTER - DEPARTMENT OF RADIOLOGY |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921039001 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
2122 |
Number Of Medicare Beneficiaries |
1106 |
Total Submitted Charge Amount |
173357 |
Total Medicare Allowed Amount |
57338.15 |
Total Medicare Payment Amount |
42070.42 |
Total Medicare Standardized Payment Amount |
40729.29 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
508 |
Number Of Beneficiaries Age 75 to 84 |
340 |
Number Of Beneficiaries Age Greater 84 |
153 |
Number Of Female Beneficiaries |
659 |
Number Of Male Beneficiaries |
447 |
Number Of Non Hispanic White Beneficiaries |
920 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
44 |
Number Of Hispanic Beneficiaries |
86 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
980 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3445 |