National Provider Identifier [NPI]: |
1932106309 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
DARRIN |
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 |
5400 W HILLSDALE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
VISALIA |
Zip Code Of The Provider |
932918222 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
131 |
Number Of Services |
31034 |
Number Of Medicare Beneficiaries |
3622 |
Total Submitted Charge Amount |
687629.67 |
Total Medicare Allowed Amount |
585110.9 |
Total Medicare Payment Amount |
463270.67 |
Total Medicare Standardized Payment Amount |
443337.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
18327 |
Number Of Medicare Beneficiaries With Drug Services |
281 |
Total Drug Submitted ChargeAmount |
3879.89 |
Total Drug Medicare AllowedAmount |
3610.83 |
Total Drug Medicare PaymentAmount |
2765.43 |
Total Drug Medicare Standardized Payment Amount |
2765.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
129 |
Number Of Medical Services |
12707 |
Number Of Medicare Beneficiaries With Medical Services |
3622 |
Total Medical Submitted Charge Amount |
683749.78 |
Total Medical Medicare Allowed Amount |
581500.07 |
Total Medical Medicare Payment Amount |
460505.24 |
Total Medical Medicare Standardized Payment Amount |
440571.72 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
193 |
Number Of Beneficiaries Age 65 to 74 |
1684 |
Number Of Beneficiaries Age 75 to 84 |
1220 |
Number Of Beneficiaries Age Greater 84 |
525 |
Number Of Female Beneficiaries |
2307 |
Number Of Male Beneficiaries |
1315 |
Number Of Non Hispanic White Beneficiaries |
2933 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
50 |
Number Of Hispanic Beneficiaries |
569 |
Number Of American Indian Alaska Native Beneficiaries |
18 |
Number Of Beneficiaries With Race Not Else where Classified |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
3363 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
259 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9935 |