National Provider Identifier [NPI]: |
1194771956 |
Last Name Of The Provider |
SIGNER |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD CM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11770 BERNARDO PLAZA COURT |
Street Address 2 Of The Provider |
SUITE 370 |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921282426 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1498 |
Number Of Medicare Beneficiaries |
360 |
Total Submitted Charge Amount |
256305 |
Total Medicare Allowed Amount |
148484.89 |
Total Medicare Payment Amount |
111590.34 |
Total Medicare Standardized Payment Amount |
108415.29 |
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 |
1498 |
Number Of Medicare Beneficiaries With Medical Services |
360 |
Total Medical Submitted Charge Amount |
256305 |
Total Medical Medicare Allowed Amount |
148484.89 |
Total Medical Medicare Payment Amount |
111590.34 |
Total Medical Medicare Standardized Payment Amount |
108415.29 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
155 |
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
206 |
Number Of Male Beneficiaries |
154 |
Number Of Non Hispanic White Beneficiaries |
293 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
19 |
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
186 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
47 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4733 |