National Provider Identifier [NPI]: |
1134270069 |
Last Name Of The Provider |
HAMILTON |
First Name Of The Provider |
SHAWN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4902 IRVINE CENTER DR |
Street Address 2 Of The Provider |
ST. 105 |
City Of The Provider |
IRVINE |
Zip Code Of The Provider |
926043305 |
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 |
18 |
Number Of Services |
402 |
Number Of Medicare Beneficiaries |
113 |
Total Submitted Charge Amount |
112835 |
Total Medicare Allowed Amount |
42829.77 |
Total Medicare Payment Amount |
31475.75 |
Total Medicare Standardized Payment Amount |
28342.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
12 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
550 |
Total Drug Medicare AllowedAmount |
259.18 |
Total Drug Medicare PaymentAmount |
248.32 |
Total Drug Medicare Standardized Payment Amount |
248.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
390 |
Number Of Medicare Beneficiaries With Medical Services |
113 |
Total Medical Submitted Charge Amount |
112285 |
Total Medical Medicare Allowed Amount |
42570.59 |
Total Medical Medicare Payment Amount |
31227.43 |
Total Medical Medicare Standardized Payment Amount |
28094.17 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
57 |
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
12 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1931 |