National Provider Identifier [NPI]: |
1386821460 |
Last Name Of The Provider |
ROUGH |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1615 SWEETWATER RD |
Street Address 2 Of The Provider |
SUITE D |
City Of The Provider |
NATIONAL CITY |
Zip Code Of The Provider |
919507655 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
1936 |
Number Of Medicare Beneficiaries |
377 |
Total Submitted Charge Amount |
310609.87 |
Total Medicare Allowed Amount |
177144.39 |
Total Medicare Payment Amount |
131846.99 |
Total Medicare Standardized Payment Amount |
129146.14 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
135 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
209 |
Number Of Male Beneficiaries |
168 |
Number Of Non Hispanic White Beneficiaries |
100 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
87 |
Number Of Hispanic Beneficiaries |
149 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
130 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
247 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.3818 |