National Provider Identifier [NPI]: |
1487737524 |
Last Name Of The Provider |
MAYWOOD |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3444 KEARNY VILLA RD |
Street Address 2 Of The Provider |
SUITE # 401 |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921231959 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
352 |
Number Of Medicare Beneficiaries |
43 |
Total Submitted Charge Amount |
142186.2 |
Total Medicare Allowed Amount |
25707.44 |
Total Medicare Payment Amount |
19117.23 |
Total Medicare Standardized Payment Amount |
18917.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
70 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
18150.28 |
Total Drug Medicare AllowedAmount |
4613.09 |
Total Drug Medicare PaymentAmount |
3616.91 |
Total Drug Medicare Standardized Payment Amount |
3616.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
282 |
Number Of Medicare Beneficiaries With Medical Services |
43 |
Total Medical Submitted Charge Amount |
124035.92 |
Total Medical Medicare Allowed Amount |
21094.35 |
Total Medical Medicare Payment Amount |
15500.32 |
Total Medical Medicare Standardized Payment Amount |
15300.56 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
21 |
Number Of Male Beneficiaries |
22 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.7456 |