National Provider Identifier [NPI]: |
1225113855 |
Last Name Of The Provider |
SIBLEY |
First Name Of The Provider |
MICHELE |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2800 L ST |
Street Address 2 Of The Provider |
SUITE 610 |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958165616 |
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 |
106 |
Number Of Services |
5712 |
Number Of Medicare Beneficiaries |
1584 |
Total Submitted Charge Amount |
903639 |
Total Medicare Allowed Amount |
236436.29 |
Total Medicare Payment Amount |
198157.67 |
Total Medicare Standardized Payment Amount |
187503.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
3085 |
Number Of Medicare Beneficiaries With Drug Services |
44 |
Total Drug Submitted ChargeAmount |
5165 |
Total Drug Medicare AllowedAmount |
1189.13 |
Total Drug Medicare PaymentAmount |
929.01 |
Total Drug Medicare Standardized Payment Amount |
929.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
102 |
Number Of Medical Services |
2627 |
Number Of Medicare Beneficiaries With Medical Services |
1584 |
Total Medical Submitted Charge Amount |
898474 |
Total Medical Medicare Allowed Amount |
235247.16 |
Total Medical Medicare Payment Amount |
197228.66 |
Total Medical Medicare Standardized Payment Amount |
186574.48 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
200 |
Number Of Beneficiaries Age 65 to 74 |
743 |
Number Of Beneficiaries Age 75 to 84 |
446 |
Number Of Beneficiaries Age Greater 84 |
195 |
Number Of Female Beneficiaries |
1249 |
Number Of Male Beneficiaries |
335 |
Number Of Non Hispanic White Beneficiaries |
1281 |
Number Of Black or African American Beneficiaries |
70 |
Number Of AsianPacific Islander Beneficiaries |
75 |
Number Of Hispanic Beneficiaries |
121 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1297 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
287 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.3034 |