National Provider Identifier [NPI]: |
1386699726 |
Last Name Of The Provider |
COUSINEAU |
First Name Of The Provider |
RUTH |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8920 WILSHIRE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEVERLY HILLS |
Zip Code Of The Provider |
902112007 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
2211 |
Number Of Medicare Beneficiaries |
548 |
Total Submitted Charge Amount |
149540 |
Total Medicare Allowed Amount |
100717.82 |
Total Medicare Payment Amount |
73806.94 |
Total Medicare Standardized Payment Amount |
67842.65 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
278 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
548 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
502 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
526 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
6 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
13 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8498 |