National Provider Identifier [NPI]: |
1154647014 |
Last Name Of The Provider |
OLIVO |
First Name Of The Provider |
RICARDO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11234 ANDERSON ST |
Street Address 2 Of The Provider |
GME OFFICE CP 21005 |
City Of The Provider |
LOMA LINDA |
Zip Code Of The Provider |
923542804 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
168 |
Number Of Medicare Beneficiaries |
112 |
Total Submitted Charge Amount |
68350 |
Total Medicare Allowed Amount |
24316.02 |
Total Medicare Payment Amount |
19063.72 |
Total Medicare Standardized Payment Amount |
18438.48 |
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 |
17 |
Number Of Medical Services |
168 |
Number Of Medicare Beneficiaries With Medical Services |
112 |
Total Medical Submitted Charge Amount |
68350 |
Total Medical Medicare Allowed Amount |
24316.02 |
Total Medical Medicare Payment Amount |
19063.72 |
Total Medical Medicare Standardized Payment Amount |
18438.48 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
55 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
85 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
84 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
29 |
Average HCC Risk Score Of Beneficiaries |
1.7854 |