National Provider Identifier [NPI]: |
1053548115 |
Last Name Of The Provider |
WEI-MESTER |
First Name Of The Provider |
SINDY |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D., PH.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10833 LE CONTE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900953097 |
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 |
29 |
Number Of Services |
133 |
Number Of Medicare Beneficiaries |
111 |
Total Submitted Charge Amount |
12912 |
Total Medicare Allowed Amount |
3799.04 |
Total Medicare Payment Amount |
2584.94 |
Total Medicare Standardized Payment Amount |
2532.47 |
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 |
29 |
Number Of Medical Services |
133 |
Number Of Medicare Beneficiaries With Medical Services |
111 |
Total Medical Submitted Charge Amount |
12912 |
Total Medical Medicare Allowed Amount |
3799.04 |
Total Medical Medicare Payment Amount |
2584.94 |
Total Medical Medicare Standardized Payment Amount |
2532.47 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
43 |
Number Of Non Hispanic White Beneficiaries |
66 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
77 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
3.4386 |