National Provider Identifier [NPI]: |
1871592683 |
Last Name Of The Provider |
STEWART |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3536 MENDOCINO AVE |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
SANTA ROSA |
Zip Code Of The Provider |
954033634 |
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 |
53 |
Number Of Services |
5384 |
Number Of Medicare Beneficiaries |
824 |
Total Submitted Charge Amount |
388242.38 |
Total Medicare Allowed Amount |
208993.98 |
Total Medicare Payment Amount |
153171.05 |
Total Medicare Standardized Payment Amount |
148764.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
3161 |
Number Of Medicare Beneficiaries With Drug Services |
215 |
Total Drug Submitted ChargeAmount |
78582 |
Total Drug Medicare AllowedAmount |
49722.09 |
Total Drug Medicare PaymentAmount |
38530.53 |
Total Drug Medicare Standardized Payment Amount |
38530.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
2223 |
Number Of Medicare Beneficiaries With Medical Services |
823 |
Total Medical Submitted Charge Amount |
309660.38 |
Total Medical Medicare Allowed Amount |
159271.89 |
Total Medical Medicare Payment Amount |
114640.52 |
Total Medical Medicare Standardized Payment Amount |
110233.96 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
261 |
Number Of Beneficiaries Age 75 to 84 |
264 |
Number Of Beneficiaries Age Greater 84 |
246 |
Number Of Female Beneficiaries |
463 |
Number Of Male Beneficiaries |
361 |
Number Of Non Hispanic White Beneficiaries |
749 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
730 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.323 |