National Provider Identifier [NPI]: |
1356335731 |
Last Name Of The Provider |
ALB |
First Name Of The Provider |
OVIDIU |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
480 4TH AVE STE 202 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHULA VISTA |
Zip Code Of The Provider |
919104412 |
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 |
30 |
Number Of Services |
743 |
Number Of Medicare Beneficiaries |
158 |
Total Submitted Charge Amount |
103322 |
Total Medicare Allowed Amount |
56239.24 |
Total Medicare Payment Amount |
39978.86 |
Total Medicare Standardized Payment Amount |
38519.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
80 |
Number Of Medicare Beneficiaries With Drug Services |
58 |
Total Drug Submitted ChargeAmount |
7035 |
Total Drug Medicare AllowedAmount |
3774.69 |
Total Drug Medicare PaymentAmount |
3697.86 |
Total Drug Medicare Standardized Payment Amount |
3697.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
663 |
Number Of Medicare Beneficiaries With Medical Services |
158 |
Total Medical Submitted Charge Amount |
96287 |
Total Medical Medicare Allowed Amount |
52464.55 |
Total Medical Medicare Payment Amount |
36281 |
Total Medical Medicare Standardized Payment Amount |
34821.81 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
63 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
77 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2632 |