National Provider Identifier [NPI]: |
1851561658 |
Last Name Of The Provider |
POP |
First Name Of The Provider |
MIHAELA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 WEST ARBOR DRIVE |
Street Address 2 Of The Provider |
UCSD MEDICAL CENTER - RAD |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921038756 |
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 |
84 |
Number Of Services |
14219 |
Number Of Medicare Beneficiaries |
940 |
Total Submitted Charge Amount |
694141.2 |
Total Medicare Allowed Amount |
206686.89 |
Total Medicare Payment Amount |
165997.42 |
Total Medicare Standardized Payment Amount |
159843.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
12884 |
Number Of Medicare Beneficiaries With Drug Services |
153 |
Total Drug Submitted ChargeAmount |
39078.2 |
Total Drug Medicare AllowedAmount |
3323.5 |
Total Drug Medicare PaymentAmount |
2605.57 |
Total Drug Medicare Standardized Payment Amount |
2605.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
1335 |
Number Of Medicare Beneficiaries With Medical Services |
940 |
Total Medical Submitted Charge Amount |
655063 |
Total Medical Medicare Allowed Amount |
203363.39 |
Total Medical Medicare Payment Amount |
163391.85 |
Total Medical Medicare Standardized Payment Amount |
157237.85 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
124 |
Number Of Beneficiaries Age 65 to 74 |
504 |
Number Of Beneficiaries Age 75 to 84 |
229 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
679 |
Number Of Male Beneficiaries |
261 |
Number Of Non Hispanic White Beneficiaries |
601 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
85 |
Number Of Hispanic Beneficiaries |
145 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
63 |
Number Of Beneficiaries With Medicare Only Entitlement |
755 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
185 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0635 |