National Provider Identifier [NPI]: |
1760666077 |
Last Name Of The Provider |
CASTREJON |
First Name Of The Provider |
SELENE |
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 |
4150 V ST |
Street Address 2 Of The Provider |
PSSB 2100 |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958171460 |
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 |
20 |
Number Of Services |
713 |
Number Of Medicare Beneficiaries |
472 |
Total Submitted Charge Amount |
196091.23 |
Total Medicare Allowed Amount |
67087.65 |
Total Medicare Payment Amount |
51119.21 |
Total Medicare Standardized Payment Amount |
50608.98 |
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 |
20 |
Number Of Medical Services |
713 |
Number Of Medicare Beneficiaries With Medical Services |
472 |
Total Medical Submitted Charge Amount |
196091.23 |
Total Medical Medicare Allowed Amount |
67087.65 |
Total Medical Medicare Payment Amount |
51119.21 |
Total Medical Medicare Standardized Payment Amount |
50608.98 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
137 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
263 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
446 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
337 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5268 |