National Provider Identifier [NPI]: |
1578582755 |
Last Name Of The Provider |
GORE |
First Name Of The Provider |
RUFUS |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
45280 SEELEY DR |
Street Address 2 Of The Provider |
2ND FLOOR |
City Of The Provider |
LA QUINTA |
Zip Code Of The Provider |
922536834 |
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 |
60 |
Number Of Services |
1389 |
Number Of Medicare Beneficiaries |
353 |
Total Submitted Charge Amount |
442803.26 |
Total Medicare Allowed Amount |
127759.07 |
Total Medicare Payment Amount |
93303.21 |
Total Medicare Standardized Payment Amount |
91652.57 |
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 |
60 |
Number Of Medical Services |
1389 |
Number Of Medicare Beneficiaries With Medical Services |
353 |
Total Medical Submitted Charge Amount |
442803.26 |
Total Medical Medicare Allowed Amount |
127759.07 |
Total Medical Medicare Payment Amount |
93303.21 |
Total Medical Medicare Standardized Payment Amount |
91652.57 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
215 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
265 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
71 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
291 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1715 |