National Provider Identifier [NPI]: |
1073504320 |
Last Name Of The Provider |
MCDONALD |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
680 GUZZI LN |
Street Address 2 Of The Provider |
SUITE #105 |
City Of The Provider |
SONORA |
Zip Code Of The Provider |
953705288 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
167 |
Number Of Services |
1606 |
Number Of Medicare Beneficiaries |
508 |
Total Submitted Charge Amount |
449521 |
Total Medicare Allowed Amount |
206818.79 |
Total Medicare Payment Amount |
159471.81 |
Total Medicare Standardized Payment Amount |
156035.77 |
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 |
167 |
Number Of Medical Services |
1606 |
Number Of Medicare Beneficiaries With Medical Services |
508 |
Total Medical Submitted Charge Amount |
449521 |
Total Medical Medicare Allowed Amount |
206818.79 |
Total Medical Medicare Payment Amount |
159471.81 |
Total Medical Medicare Standardized Payment Amount |
156035.77 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
225 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
299 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
469 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
402 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1165 |