National Provider Identifier [NPI]: |
1073600318 |
Last Name Of The Provider |
SACHS |
First Name Of The Provider |
NEIL |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
DMD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
39000 BOB HOPE DR |
Street Address 2 Of The Provider |
W410 |
City Of The Provider |
RANCHO MIRAGE |
Zip Code Of The Provider |
922703221 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Oral Surgery (dentists only) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
518 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
46697.52 |
Total Medicare Allowed Amount |
26686.29 |
Total Medicare Payment Amount |
19837.13 |
Total Medicare Standardized Payment Amount |
19406.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
518 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
46697.52 |
Total Medical Medicare Allowed Amount |
26686.29 |
Total Medical Medicare Payment Amount |
19837.13 |
Total Medical Medicare Standardized Payment Amount |
19406.95 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
203 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0375 |