National Provider Identifier [NPI]: |
1174502223 |
Last Name Of The Provider |
SUMMERS |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
786 3RD AVE |
Street Address 2 Of The Provider |
#B |
City Of The Provider |
CHULA VISTA |
Zip Code Of The Provider |
919105826 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
553 |
Number Of Medicare Beneficiaries |
182 |
Total Submitted Charge Amount |
302993.84 |
Total Medicare Allowed Amount |
121263.6 |
Total Medicare Payment Amount |
93459.48 |
Total Medicare Standardized Payment Amount |
92501.31 |
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 |
62 |
Number Of Medical Services |
553 |
Number Of Medicare Beneficiaries With Medical Services |
182 |
Total Medical Submitted Charge Amount |
302993.84 |
Total Medical Medicare Allowed Amount |
121263.6 |
Total Medical Medicare Payment Amount |
93459.48 |
Total Medical Medicare Standardized Payment Amount |
92501.31 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
69 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
88 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
76 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.4739 |