National Provider Identifier [NPI]: |
1710949821 |
Last Name Of The Provider |
BUDMAN |
First Name Of The Provider |
MARGO |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5300 SNYDER LN |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
ROHNERT PARK |
Zip Code Of The Provider |
949282915 |
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 |
23 |
Number Of Services |
338 |
Number Of Medicare Beneficiaries |
115 |
Total Submitted Charge Amount |
62274 |
Total Medicare Allowed Amount |
24996.22 |
Total Medicare Payment Amount |
19267.99 |
Total Medicare Standardized Payment Amount |
18511.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
3231 |
Total Drug Medicare AllowedAmount |
1781.48 |
Total Drug Medicare PaymentAmount |
1745.83 |
Total Drug Medicare Standardized Payment Amount |
1745.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
286 |
Number Of Medicare Beneficiaries With Medical Services |
114 |
Total Medical Submitted Charge Amount |
59043 |
Total Medical Medicare Allowed Amount |
23214.74 |
Total Medical Medicare Payment Amount |
17522.16 |
Total Medical Medicare Standardized Payment Amount |
16765.89 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
100 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
103 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
23 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0082 |