National Provider Identifier [NPI]: |
1104811330 |
Last Name Of The Provider |
STUART |
First Name Of The Provider |
PATRICK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1570 E HERNDON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937203303 |
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 |
49 |
Number Of Services |
1684 |
Number Of Medicare Beneficiaries |
301 |
Total Submitted Charge Amount |
202630 |
Total Medicare Allowed Amount |
123644.21 |
Total Medicare Payment Amount |
86228.88 |
Total Medicare Standardized Payment Amount |
83565.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
292 |
Number Of Medicare Beneficiaries With Drug Services |
167 |
Total Drug Submitted ChargeAmount |
10918 |
Total Drug Medicare AllowedAmount |
4964.26 |
Total Drug Medicare PaymentAmount |
4614.81 |
Total Drug Medicare Standardized Payment Amount |
4614.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
1392 |
Number Of Medicare Beneficiaries With Medical Services |
300 |
Total Medical Submitted Charge Amount |
191712 |
Total Medical Medicare Allowed Amount |
118679.95 |
Total Medical Medicare Payment Amount |
81614.07 |
Total Medical Medicare Standardized Payment Amount |
78951.04 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
245 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
277 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9031 |