National Provider Identifier [NPI]: |
1790779478 |
Last Name Of The Provider |
GREENBERG |
First Name Of The Provider |
ROY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 CREEKSIDE DR |
Street Address 2 Of The Provider |
STE 2100 |
City Of The Provider |
FOLSOM |
Zip Code Of The Provider |
956303444 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
2015 |
Number Of Medicare Beneficiaries |
309 |
Total Submitted Charge Amount |
266347 |
Total Medicare Allowed Amount |
137496.7 |
Total Medicare Payment Amount |
102291.32 |
Total Medicare Standardized Payment Amount |
99191.32 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
318 |
Number Of Medicare Beneficiaries With Drug Services |
211 |
Total Drug Submitted ChargeAmount |
38095 |
Total Drug Medicare AllowedAmount |
19751.7 |
Total Drug Medicare PaymentAmount |
19349.82 |
Total Drug Medicare Standardized Payment Amount |
19349.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1697 |
Number Of Medicare Beneficiaries With Medical Services |
309 |
Total Medical Submitted Charge Amount |
228252 |
Total Medical Medicare Allowed Amount |
117745 |
Total Medical Medicare Payment Amount |
82941.5 |
Total Medical Medicare Standardized Payment Amount |
79841.5 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
206 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
166 |
Number Of Non Hispanic White Beneficiaries |
278 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
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 |
7 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
4 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
19 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.7925 |