National Provider Identifier [NPI]: |
1295013951 |
Last Name Of The Provider |
PETER |
First Name Of The Provider |
NEIVEEN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1798 N GAREY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
POMONA |
Zip Code Of The Provider |
917672918 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
159 |
Number Of Medicare Beneficiaries |
85 |
Total Submitted Charge Amount |
33721 |
Total Medicare Allowed Amount |
16770.07 |
Total Medicare Payment Amount |
12677.67 |
Total Medicare Standardized Payment Amount |
12113.94 |
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 |
159 |
Number Of Medicare Beneficiaries With Medical Services |
85 |
Total Medical Submitted Charge Amount |
33721 |
Total Medical Medicare Allowed Amount |
16770.07 |
Total Medical Medicare Payment Amount |
12677.67 |
Total Medical Medicare Standardized Payment Amount |
12113.94 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
19 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
30 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
35 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
31 |
Average HCC Risk Score Of Beneficiaries |
3.1899 |