National Provider Identifier [NPI]: |
1831114800 |
Last Name Of The Provider |
GALE |
First Name Of The Provider |
IAN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18370 BURBANK BLVD |
Street Address 2 Of The Provider |
STE 407 |
City Of The Provider |
TARZANA |
Zip Code Of The Provider |
913562804 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
8393 |
Number Of Medicare Beneficiaries |
406 |
Total Submitted Charge Amount |
762530 |
Total Medicare Allowed Amount |
360741.5 |
Total Medicare Payment Amount |
279040.56 |
Total Medicare Standardized Payment Amount |
257103.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
2863 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
38145 |
Total Drug Medicare AllowedAmount |
13567.94 |
Total Drug Medicare PaymentAmount |
10629.03 |
Total Drug Medicare Standardized Payment Amount |
10629.03 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
5530 |
Number Of Medicare Beneficiaries With Medical Services |
406 |
Total Medical Submitted Charge Amount |
724385 |
Total Medical Medicare Allowed Amount |
347173.56 |
Total Medical Medicare Payment Amount |
268411.53 |
Total Medical Medicare Standardized Payment Amount |
246474.5 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
171 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
95 |
Number Of Male Beneficiaries |
311 |
Number Of Non Hispanic White Beneficiaries |
364 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
374 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1244 |