National Provider Identifier [NPI]: |
1386687341 |
Last Name Of The Provider |
STORMO |
First Name Of The Provider |
OWEN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
PUEBLO AT BATH |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA BARBARA |
Zip Code Of The Provider |
93105 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
926 |
Number Of Medicare Beneficiaries |
532 |
Total Submitted Charge Amount |
377725 |
Total Medicare Allowed Amount |
95472.25 |
Total Medicare Payment Amount |
73785.24 |
Total Medicare Standardized Payment Amount |
72962.33 |
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 |
34 |
Number Of Medical Services |
926 |
Number Of Medicare Beneficiaries With Medical Services |
532 |
Total Medical Submitted Charge Amount |
377725 |
Total Medical Medicare Allowed Amount |
95472.25 |
Total Medical Medicare Payment Amount |
73785.24 |
Total Medical Medicare Standardized Payment Amount |
72962.33 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
151 |
Number Of Female Beneficiaries |
284 |
Number Of Male Beneficiaries |
248 |
Number Of Non Hispanic White Beneficiaries |
410 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
94 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
366 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
166 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6846 |