National Provider Identifier [NPI]: |
1093020638 |
Last Name Of The Provider |
HA |
First Name Of The Provider |
RAYMOND |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1700 MOUNT VERNON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BAKERSFIELD |
Zip Code Of The Provider |
933064018 |
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 |
22 |
Number Of Services |
743 |
Number Of Medicare Beneficiaries |
278 |
Total Submitted Charge Amount |
261768 |
Total Medicare Allowed Amount |
98274.54 |
Total Medicare Payment Amount |
76163.91 |
Total Medicare Standardized Payment Amount |
67014.94 |
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 |
22 |
Number Of Medical Services |
743 |
Number Of Medicare Beneficiaries With Medical Services |
278 |
Total Medical Submitted Charge Amount |
261768 |
Total Medical Medicare Allowed Amount |
98274.54 |
Total Medical Medicare Payment Amount |
76163.91 |
Total Medical Medicare Standardized Payment Amount |
67014.94 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
136 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
85 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
99 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
179 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.2703 |