National Provider Identifier [NPI]: |
1063458495 |
Last Name Of The Provider |
DEFELICE |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1485 RIVER PARK DR |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958154530 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1743 |
Number Of Medicare Beneficiaries |
596 |
Total Submitted Charge Amount |
709603 |
Total Medicare Allowed Amount |
245530.62 |
Total Medicare Payment Amount |
189573.48 |
Total Medicare Standardized Payment Amount |
187179.16 |
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 |
21 |
Number Of Medical Services |
1743 |
Number Of Medicare Beneficiaries With Medical Services |
596 |
Total Medical Submitted Charge Amount |
709603 |
Total Medical Medicare Allowed Amount |
245530.62 |
Total Medical Medicare Payment Amount |
189573.48 |
Total Medical Medicare Standardized Payment Amount |
187179.16 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
217 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
339 |
Number Of Male Beneficiaries |
257 |
Number Of Non Hispanic White Beneficiaries |
319 |
Number Of Black or African American Beneficiaries |
70 |
Number Of AsianPacific Islander Beneficiaries |
125 |
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
272 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
324 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.4125 |