National Provider Identifier [NPI]: |
1184690901 |
Last Name Of The Provider |
STEWART |
First Name Of The Provider |
CARY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1001 AVENIDA PICO |
Street Address 2 Of The Provider |
SUITE C |
City Of The Provider |
SAN CLEMENTE |
Zip Code Of The Provider |
926736957 |
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 |
15 |
Number Of Services |
354 |
Number Of Medicare Beneficiaries |
72 |
Total Submitted Charge Amount |
52484.74 |
Total Medicare Allowed Amount |
43828 |
Total Medicare Payment Amount |
33023.04 |
Total Medicare Standardized Payment Amount |
32385.54 |
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 |
15 |
Number Of Medical Services |
354 |
Number Of Medicare Beneficiaries With Medical Services |
72 |
Total Medical Submitted Charge Amount |
52484.74 |
Total Medical Medicare Allowed Amount |
43828 |
Total Medical Medicare Payment Amount |
33023.04 |
Total Medical Medicare Standardized Payment Amount |
32385.54 |
Average Age Of Beneficiaries |
86 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
49 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
51 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
50 |
Percent Of With Asthma |
|
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.667 |