National Provider Identifier [NPI]: |
1518154814 |
Last Name Of The Provider |
BLANDO |
First Name Of The Provider |
LUIS |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D, |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
430 PARK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORT HUENEME |
Zip Code Of The Provider |
930412553 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1395 |
Number Of Medicare Beneficiaries |
314 |
Total Submitted Charge Amount |
87832 |
Total Medicare Allowed Amount |
74547.5 |
Total Medicare Payment Amount |
44074.03 |
Total Medicare Standardized Payment Amount |
40734.14 |
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 |
1395 |
Number Of Medicare Beneficiaries With Medical Services |
314 |
Total Medical Submitted Charge Amount |
87832 |
Total Medical Medicare Allowed Amount |
74547.5 |
Total Medical Medicare Payment Amount |
44074.03 |
Total Medical Medicare Standardized Payment Amount |
40734.14 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
122 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
166 |
Number Of Hispanic Beneficiaries |
108 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
146 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
5 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.0835 |