National Provider Identifier [NPI]: |
1184763633 |
Last Name Of The Provider |
FINSTAD |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6425 LYNCH CANYON DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKE ISABELLA |
Zip Code Of The Provider |
932409726 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
2094 |
Number Of Medicare Beneficiaries |
476 |
Total Submitted Charge Amount |
200522 |
Total Medicare Allowed Amount |
142212.87 |
Total Medicare Payment Amount |
92485.71 |
Total Medicare Standardized Payment Amount |
89067.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
377 |
Number Of Medicare Beneficiaries With Drug Services |
134 |
Total Drug Submitted ChargeAmount |
3999 |
Total Drug Medicare AllowedAmount |
989.84 |
Total Drug Medicare PaymentAmount |
869.28 |
Total Drug Medicare Standardized Payment Amount |
869.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
1717 |
Number Of Medicare Beneficiaries With Medical Services |
476 |
Total Medical Submitted Charge Amount |
196523 |
Total Medical Medicare Allowed Amount |
141223.03 |
Total Medical Medicare Payment Amount |
91616.43 |
Total Medical Medicare Standardized Payment Amount |
88198.22 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
195 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
229 |
Number Of Male Beneficiaries |
247 |
Number Of Non Hispanic White Beneficiaries |
449 |
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 |
365 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1309 |