National Provider Identifier [NPI]: |
1689796674 |
Last Name Of The Provider |
KELMENSON-CHAU |
First Name Of The Provider |
SARAH |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3010 COLBY ST |
Street Address 2 Of The Provider |
SUITE 212 |
City Of The Provider |
BERKELEY |
Zip Code Of The Provider |
947052059 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
819 |
Number Of Medicare Beneficiaries |
501 |
Total Submitted Charge Amount |
269675 |
Total Medicare Allowed Amount |
85265.56 |
Total Medicare Payment Amount |
65608.28 |
Total Medicare Standardized Payment Amount |
61885.28 |
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 |
36 |
Number Of Medical Services |
819 |
Number Of Medicare Beneficiaries With Medical Services |
501 |
Total Medical Submitted Charge Amount |
269675 |
Total Medical Medicare Allowed Amount |
85265.56 |
Total Medical Medicare Payment Amount |
65608.28 |
Total Medical Medicare Standardized Payment Amount |
61885.28 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
134 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
107 |
Number Of Female Beneficiaries |
279 |
Number Of Male Beneficiaries |
222 |
Number Of Non Hispanic White Beneficiaries |
194 |
Number Of Black or African American Beneficiaries |
194 |
Number Of AsianPacific Islander Beneficiaries |
74 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
210 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
291 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.8777 |