National Provider Identifier [NPI]: |
1144261637 |
Last Name Of The Provider |
LEVINSON |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
SANTA ROSA MEMORIAL HOSPITAL |
Street Address 2 Of The Provider |
1165 MONTGOMERY DRIVE |
City Of The Provider |
SANTA ROSA |
Zip Code Of The Provider |
954054897 |
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 |
55 |
Number Of Services |
1635 |
Number Of Medicare Beneficiaries |
812 |
Total Submitted Charge Amount |
517678.1 |
Total Medicare Allowed Amount |
156586.93 |
Total Medicare Payment Amount |
119429 |
Total Medicare Standardized Payment Amount |
112416.49 |
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 |
55 |
Number Of Medical Services |
1635 |
Number Of Medicare Beneficiaries With Medical Services |
812 |
Total Medical Submitted Charge Amount |
517678.1 |
Total Medical Medicare Allowed Amount |
156586.93 |
Total Medical Medicare Payment Amount |
119429 |
Total Medical Medicare Standardized Payment Amount |
112416.49 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
247 |
Number Of Beneficiaries Age 65 to 74 |
213 |
Number Of Beneficiaries Age 75 to 84 |
198 |
Number Of Beneficiaries Age Greater 84 |
154 |
Number Of Female Beneficiaries |
465 |
Number Of Male Beneficiaries |
347 |
Number Of Non Hispanic White Beneficiaries |
519 |
Number Of Black or African American Beneficiaries |
92 |
Number Of AsianPacific Islander Beneficiaries |
67 |
Number Of Hispanic Beneficiaries |
115 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
431 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
381 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.2932 |