National Provider Identifier [NPI]: |
1114086865 |
Last Name Of The Provider |
SAUL |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4733 W SUNSET BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900276021 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
181 |
Number Of Medicare Beneficiaries |
118 |
Total Submitted Charge Amount |
10400 |
Total Medicare Allowed Amount |
2239.05 |
Total Medicare Payment Amount |
1670.19 |
Total Medicare Standardized Payment Amount |
1555.42 |
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 |
32 |
Number Of Medical Services |
181 |
Number Of Medicare Beneficiaries With Medical Services |
118 |
Total Medical Submitted Charge Amount |
10400 |
Total Medical Medicare Allowed Amount |
2239.05 |
Total Medical Medicare Payment Amount |
1670.19 |
Total Medical Medicare Standardized Payment Amount |
1555.42 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
48 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
40 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.8772 |