National Provider Identifier [NPI]: |
1720052541 |
Last Name Of The Provider |
GISI |
First Name Of The Provider |
SYLVIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
31493 RANCHO PUEBLO |
Street Address 2 Of The Provider |
SUITE 204 |
City Of The Provider |
TEMECULA |
Zip Code Of The Provider |
925924833 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
1695 |
Number Of Medicare Beneficiaries |
283 |
Total Submitted Charge Amount |
161774.58 |
Total Medicare Allowed Amount |
112513.91 |
Total Medicare Payment Amount |
82016.27 |
Total Medicare Standardized Payment Amount |
79698.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
249 |
Number Of Medicare Beneficiaries With Drug Services |
172 |
Total Drug Submitted ChargeAmount |
12725.3 |
Total Drug Medicare AllowedAmount |
9917.35 |
Total Drug Medicare PaymentAmount |
9705.97 |
Total Drug Medicare Standardized Payment Amount |
9705.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
1446 |
Number Of Medicare Beneficiaries With Medical Services |
283 |
Total Medical Submitted Charge Amount |
149049.28 |
Total Medical Medicare Allowed Amount |
102596.56 |
Total Medical Medicare Payment Amount |
72310.3 |
Total Medical Medicare Standardized Payment Amount |
69992.98 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
211 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9198 |