National Provider Identifier [NPI]: |
1548473507 |
Last Name Of The Provider |
BORSO |
First Name Of The Provider |
MAYA |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6256 GREENWICH DR STE 150 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921225965 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
156 |
Number Of Services |
6870 |
Number Of Medicare Beneficiaries |
1653 |
Total Submitted Charge Amount |
1117829.57 |
Total Medicare Allowed Amount |
209093.6 |
Total Medicare Payment Amount |
162806.84 |
Total Medicare Standardized Payment Amount |
155737.13 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
4376 |
Number Of Medicare Beneficiaries With Drug Services |
94 |
Total Drug Submitted ChargeAmount |
28447 |
Total Drug Medicare AllowedAmount |
2897.26 |
Total Drug Medicare PaymentAmount |
2271.4 |
Total Drug Medicare Standardized Payment Amount |
2271.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
149 |
Number Of Medical Services |
2494 |
Number Of Medicare Beneficiaries With Medical Services |
1653 |
Total Medical Submitted Charge Amount |
1089382.57 |
Total Medical Medicare Allowed Amount |
206196.34 |
Total Medical Medicare Payment Amount |
160535.44 |
Total Medical Medicare Standardized Payment Amount |
153465.73 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
282 |
Number Of Beneficiaries Age 65 to 74 |
696 |
Number Of Beneficiaries Age 75 to 84 |
419 |
Number Of Beneficiaries Age Greater 84 |
256 |
Number Of Female Beneficiaries |
1031 |
Number Of Male Beneficiaries |
622 |
Number Of Non Hispanic White Beneficiaries |
1137 |
Number Of Black or African American Beneficiaries |
164 |
Number Of AsianPacific Islander Beneficiaries |
88 |
Number Of Hispanic Beneficiaries |
218 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1014 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
639 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7716 |