National Provider Identifier [NPI]: |
1205030665 |
Last Name Of The Provider |
SNODGRESS |
First Name Of The Provider |
SEAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
PUEBLO AT BATH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA BARBARA |
Zip Code Of The Provider |
931020689 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
190 |
Number Of Services |
18955 |
Number Of Medicare Beneficiaries |
3167 |
Total Submitted Charge Amount |
1692473.14 |
Total Medicare Allowed Amount |
545348.39 |
Total Medicare Payment Amount |
423295.94 |
Total Medicare Standardized Payment Amount |
412611.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
13760 |
Number Of Medicare Beneficiaries With Drug Services |
178 |
Total Drug Submitted ChargeAmount |
16352 |
Total Drug Medicare AllowedAmount |
3623.79 |
Total Drug Medicare PaymentAmount |
2747.93 |
Total Drug Medicare Standardized Payment Amount |
2747.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
185 |
Number Of Medical Services |
5195 |
Number Of Medicare Beneficiaries With Medical Services |
3167 |
Total Medical Submitted Charge Amount |
1676121.14 |
Total Medical Medicare Allowed Amount |
541724.6 |
Total Medical Medicare Payment Amount |
420548.01 |
Total Medical Medicare Standardized Payment Amount |
409863.16 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
335 |
Number Of Beneficiaries Age 65 to 74 |
1265 |
Number Of Beneficiaries Age 75 to 84 |
998 |
Number Of Beneficiaries Age Greater 84 |
569 |
Number Of Female Beneficiaries |
1929 |
Number Of Male Beneficiaries |
1238 |
Number Of Non Hispanic White Beneficiaries |
2551 |
Number Of Black or African American Beneficiaries |
65 |
Number Of AsianPacific Islander Beneficiaries |
55 |
Number Of Hispanic Beneficiaries |
419 |
Number Of American Indian Alaska Native Beneficiaries |
25 |
Number Of Beneficiaries With Race Not Else where Classified |
52 |
Number Of Beneficiaries With Medicare Only Entitlement |
2625 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
542 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4199 |