National Provider Identifier [NPI]: |
1700875911 |
Last Name Of The Provider |
TRAM |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
293 S MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ORANGE |
Zip Code Of The Provider |
928683843 |
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 |
75 |
Number Of Services |
1087 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
123410 |
Total Medicare Allowed Amount |
77942.69 |
Total Medicare Payment Amount |
54454.69 |
Total Medicare Standardized Payment Amount |
48834.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
98 |
Number Of Medicare Beneficiaries With Drug Services |
44 |
Total Drug Submitted ChargeAmount |
3484 |
Total Drug Medicare AllowedAmount |
1403.12 |
Total Drug Medicare PaymentAmount |
1345.2 |
Total Drug Medicare Standardized Payment Amount |
1345.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
989 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
119926 |
Total Medical Medicare Allowed Amount |
76539.57 |
Total Medical Medicare Payment Amount |
53109.49 |
Total Medical Medicare Standardized Payment Amount |
47489.46 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
104 |
Number Of Non Hispanic White Beneficiaries |
148 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
41 |
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 |
165 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.7505 |