| National Provider Identifier [NPI]: |
1184658973 |
| Last Name Of The Provider |
REN |
| First Name Of The Provider |
XING |
| Middle Initial Of The Provider |
J |
| Credentials Of The Provider |
M.D. |
| Gender Of The Provider |
M |
| Entity Type Of The Provider |
I |
| Street Address 1 Of The Provider |
SCRIPPS CLINIC |
| Street Address 2 Of The Provider |
2020 GENESSE AVENUE |
| City Of The Provider |
SAN DIEGO |
| Zip Code Of The Provider |
92123 |
| 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 |
29 |
| Number Of Services |
974 |
| Number Of Medicare Beneficiaries |
242 |
| Total Submitted Charge Amount |
166717.5 |
| Total Medicare Allowed Amount |
86712.05 |
| Total Medicare Payment Amount |
62215.94 |
| Total Medicare Standardized Payment Amount |
60200.03 |
| Drug Suppress Indicator |
|
| Number Of HCPCS Associated With Drug Services |
10 |
| Number Of Drug Services |
114 |
| Number Of Medicare Beneficiaries With Drug Services |
89 |
| Total Drug Submitted ChargeAmount |
4545.5 |
| Total Drug Medicare AllowedAmount |
2096.67 |
| Total Drug Medicare PaymentAmount |
2038.1 |
| Total Drug Medicare Standardized Payment Amount |
2038.1 |
| Medical SuppressIndicator |
|
| Number Of HCPCS Associated With MedicalServices |
19 |
| Number Of Medical Services |
860 |
| Number Of Medicare Beneficiaries With Medical Services |
242 |
| Total Medical Submitted Charge Amount |
162172 |
| Total Medical Medicare Allowed Amount |
84615.38 |
| Total Medical Medicare Payment Amount |
60177.84 |
| Total Medical Medicare Standardized Payment Amount |
58161.93 |
| Average Age Of Beneficiaries |
76 |
| Number Of Beneficiaries Age Less65 |
17 |
| Number Of Beneficiaries Age 65 to 74 |
97 |
| Number Of Beneficiaries Age 75 to 84 |
83 |
| Number Of Beneficiaries Age Greater 84 |
45 |
| Number Of Female Beneficiaries |
113 |
| Number Of Male Beneficiaries |
129 |
| Number Of Non Hispanic White Beneficiaries |
173 |
| Number Of Black or African American Beneficiaries |
|
| Number Of AsianPacific Islander Beneficiaries |
29 |
| Number Of Hispanic Beneficiaries |
22 |
| Number Of American Indian Alaska Native Beneficiaries |
|
| Number Of Beneficiaries With Race Not Else where Classified |
|
| Number Of Beneficiaries With Medicare Only Entitlement |
216 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
| Percent Of With Atrial Fibrillation |
13 |
| Percent Of With Alzheimers Disease or Dementia |
10 |
| Percent Of With Asthma |
5 |
| Percent Of With Cancer |
11 |
| Percent Of With Heart Failure |
13 |
| Percent Of With Chronic Kidney Disease |
17 |
| Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
| Percent Of With Depression |
23 |
| Percent Of With Diabetes |
27 |
| Percent Of With Hyperlipidemia |
75 |
| Percent Of With Hypertension |
72 |
| Percent Of With Ischemic Heart Disease |
28 |
| Percent Of With Osteoporosis |
7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
| Percent Of With Schizophrenia Other PsychoticDisorders |
|
| Percent Of With Stroke |
|
| Average HCC Risk Score Of Beneficiaries |
1.105 |