National Provider Identifier [NPI]: |
1265455448 |
Last Name Of The Provider |
MCAULIFFE |
First Name Of The Provider |
NAOMI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
510 DOYLE PARK DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA ROSA |
Zip Code Of The Provider |
954054570 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
1061 |
Number Of Medicare Beneficiaries |
272 |
Total Submitted Charge Amount |
147994 |
Total Medicare Allowed Amount |
59633.63 |
Total Medicare Payment Amount |
45670.44 |
Total Medicare Standardized Payment Amount |
43899.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
305 |
Number Of Medicare Beneficiaries With Drug Services |
86 |
Total Drug Submitted ChargeAmount |
5896 |
Total Drug Medicare AllowedAmount |
2882.35 |
Total Drug Medicare PaymentAmount |
2787.1 |
Total Drug Medicare Standardized Payment Amount |
2787.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
756 |
Number Of Medicare Beneficiaries With Medical Services |
272 |
Total Medical Submitted Charge Amount |
142098 |
Total Medical Medicare Allowed Amount |
56751.28 |
Total Medical Medicare Payment Amount |
42883.34 |
Total Medical Medicare Standardized Payment Amount |
41112.58 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
224 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
246 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
251 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
8 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
11 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
35 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7456 |