National Provider Identifier [NPI]: |
1699964700 |
Last Name Of The Provider |
HOLT |
First Name Of The Provider |
ZACHARY |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4150 V ST |
Street Address 2 Of The Provider |
SUITE # 3116 |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958171460 |
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 |
901 |
Number Of Medicare Beneficiaries |
389 |
Total Submitted Charge Amount |
201760 |
Total Medicare Allowed Amount |
69383.57 |
Total Medicare Payment Amount |
50316.87 |
Total Medicare Standardized Payment Amount |
49269.85 |
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 |
24 |
Number Of Medical Services |
901 |
Number Of Medicare Beneficiaries With Medical Services |
389 |
Total Medical Submitted Charge Amount |
201760 |
Total Medical Medicare Allowed Amount |
69383.57 |
Total Medical Medicare Payment Amount |
50316.87 |
Total Medical Medicare Standardized Payment Amount |
49269.85 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
149 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
236 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
198 |
Number Of Black or African American Beneficiaries |
81 |
Number Of AsianPacific Islander Beneficiaries |
40 |
Number Of Hispanic Beneficiaries |
55 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
131 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
258 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
2.0377 |