National Provider Identifier [NPI]: |
1568495042 |
Last Name Of The Provider |
PERTSCH |
First Name Of The Provider |
SUZANNE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1501 TROUSDALE DR |
Street Address 2 Of The Provider |
3RD FLOOR |
City Of The Provider |
BURLINGAME |
Zip Code Of The Provider |
940104506 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
711 |
Number Of Medicare Beneficiaries |
249 |
Total Submitted Charge Amount |
137623 |
Total Medicare Allowed Amount |
89913.65 |
Total Medicare Payment Amount |
69532.52 |
Total Medicare Standardized Payment Amount |
58789.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
14 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
1120 |
Total Drug Medicare AllowedAmount |
1089.9 |
Total Drug Medicare PaymentAmount |
1068.06 |
Total Drug Medicare Standardized Payment Amount |
1068.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
697 |
Number Of Medicare Beneficiaries With Medical Services |
249 |
Total Medical Submitted Charge Amount |
136503 |
Total Medical Medicare Allowed Amount |
88823.75 |
Total Medical Medicare Payment Amount |
68464.46 |
Total Medical Medicare Standardized Payment Amount |
57721.69 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
204 |
Number Of Male Beneficiaries |
45 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5747 |