National Provider Identifier [NPI]: |
1699941039 |
Last Name Of The Provider |
SOSNOWSKI |
First Name Of The Provider |
RAFAL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
39000 BOB HOPE DRIVE |
Street Address 2 Of The Provider |
|
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 |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
245 |
Number Of Services |
93305 |
Number Of Medicare Beneficiaries |
5682 |
Total Submitted Charge Amount |
6006300.84 |
Total Medicare Allowed Amount |
1679255.34 |
Total Medicare Payment Amount |
1282426.87 |
Total Medicare Standardized Payment Amount |
1259011.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
83267 |
Number Of Medicare Beneficiaries With Drug Services |
1118 |
Total Drug Submitted ChargeAmount |
126687 |
Total Drug Medicare AllowedAmount |
24981.8 |
Total Drug Medicare PaymentAmount |
19552.71 |
Total Drug Medicare Standardized Payment Amount |
19552.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
239 |
Number Of Medical Services |
10038 |
Number Of Medicare Beneficiaries With Medical Services |
5682 |
Total Medical Submitted Charge Amount |
5879613.84 |
Total Medical Medicare Allowed Amount |
1654273.54 |
Total Medical Medicare Payment Amount |
1262874.16 |
Total Medical Medicare Standardized Payment Amount |
1239459.22 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
377 |
Number Of Beneficiaries Age 65 to 74 |
2087 |
Number Of Beneficiaries Age 75 to 84 |
2102 |
Number Of Beneficiaries Age Greater 84 |
1116 |
Number Of Female Beneficiaries |
3125 |
Number Of Male Beneficiaries |
2557 |
Number Of Non Hispanic White Beneficiaries |
4991 |
Number Of Black or African American Beneficiaries |
74 |
Number Of AsianPacific Islander Beneficiaries |
54 |
Number Of Hispanic Beneficiaries |
483 |
Number Of American Indian Alaska Native Beneficiaries |
19 |
Number Of Beneficiaries With Race Not Else where Classified |
61 |
Number Of Beneficiaries With Medicare Only Entitlement |
5030 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
652 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5951 |