National Provider Identifier [NPI]: |
1356562789 |
Last Name Of The Provider |
FARR |
First Name Of The Provider |
SARA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2375 FOREST AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN JOSE |
Zip Code Of The Provider |
951284610 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
935 |
Number Of Medicare Beneficiaries |
315 |
Total Submitted Charge Amount |
281518.5 |
Total Medicare Allowed Amount |
108245.04 |
Total Medicare Payment Amount |
84623.53 |
Total Medicare Standardized Payment Amount |
75211.29 |
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 |
15 |
Number Of Medical Services |
935 |
Number Of Medicare Beneficiaries With Medical Services |
315 |
Total Medical Submitted Charge Amount |
281518.5 |
Total Medical Medicare Allowed Amount |
108245.04 |
Total Medical Medicare Payment Amount |
84623.53 |
Total Medical Medicare Standardized Payment Amount |
75211.29 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
96 |
Number Of Beneficiaries Age Greater 84 |
102 |
Number Of Female Beneficiaries |
179 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
187 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
62 |
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
166 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
149 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.4401 |