National Provider Identifier [NPI]: |
1770671455 |
Last Name Of The Provider |
FEARON |
First Name Of The Provider |
WILLIAM |
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 |
300 PASTEUR DR |
Street Address 2 Of The Provider |
H2103 |
City Of The Provider |
STANFORD |
Zip Code Of The Provider |
943052200 |
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 |
39 |
Number Of Services |
850 |
Number Of Medicare Beneficiaries |
531 |
Total Submitted Charge Amount |
2343559.5 |
Total Medicare Allowed Amount |
268668.49 |
Total Medicare Payment Amount |
207894.57 |
Total Medicare Standardized Payment Amount |
195675.74 |
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 |
39 |
Number Of Medical Services |
850 |
Number Of Medicare Beneficiaries With Medical Services |
531 |
Total Medical Submitted Charge Amount |
2343559.5 |
Total Medical Medicare Allowed Amount |
268668.49 |
Total Medical Medicare Payment Amount |
207894.57 |
Total Medical Medicare Standardized Payment Amount |
195675.74 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
174 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
118 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
328 |
Number Of Non Hispanic White Beneficiaries |
365 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
74 |
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
408 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
123 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.3106 |