National Provider Identifier [NPI]: |
1134132251 |
Last Name Of The Provider |
HAMILTON |
First Name Of The Provider |
VAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
215 PESETAS LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA BARBARA |
Zip Code Of The Provider |
931101416 |
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 |
461 |
Number Of Medicare Beneficiaries |
189 |
Total Submitted Charge Amount |
75340 |
Total Medicare Allowed Amount |
39834.6 |
Total Medicare Payment Amount |
27065.64 |
Total Medicare Standardized Payment Amount |
26189.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
7648 |
Total Drug Medicare AllowedAmount |
2838.14 |
Total Drug Medicare PaymentAmount |
2761.84 |
Total Drug Medicare Standardized Payment Amount |
2761.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
420 |
Number Of Medicare Beneficiaries With Medical Services |
188 |
Total Medical Submitted Charge Amount |
67692 |
Total Medical Medicare Allowed Amount |
36996.46 |
Total Medical Medicare Payment Amount |
24303.8 |
Total Medical Medicare Standardized Payment Amount |
23427.76 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
100 |
Number Of Non Hispanic White Beneficiaries |
156 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
177 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
12 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8873 |