National Provider Identifier [NPI]: |
1386657195 |
Last Name Of The Provider |
RICHARDS |
First Name Of The Provider |
KRISTEN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9850 GENESEE AVE |
Street Address 2 Of The Provider |
SUITE 460 |
City Of The Provider |
LA JOLLA |
Zip Code Of The Provider |
920371228 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
7784 |
Number Of Medicare Beneficiaries |
771 |
Total Submitted Charge Amount |
1299372.4 |
Total Medicare Allowed Amount |
817683.84 |
Total Medicare Payment Amount |
625126.09 |
Total Medicare Standardized Payment Amount |
579362.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
126 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
11155.76 |
Total Drug Medicare AllowedAmount |
8597.27 |
Total Drug Medicare PaymentAmount |
6738.83 |
Total Drug Medicare Standardized Payment Amount |
6738.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
106 |
Number Of Medical Services |
7658 |
Number Of Medicare Beneficiaries With Medical Services |
771 |
Total Medical Submitted Charge Amount |
1288216.64 |
Total Medical Medicare Allowed Amount |
809086.57 |
Total Medical Medicare Payment Amount |
618387.26 |
Total Medical Medicare Standardized Payment Amount |
572623.93 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
355 |
Number Of Beneficiaries Age 75 to 84 |
263 |
Number Of Beneficiaries Age Greater 84 |
142 |
Number Of Female Beneficiaries |
423 |
Number Of Male Beneficiaries |
348 |
Number Of Non Hispanic White Beneficiaries |
741 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.9332 |