National Provider Identifier [NPI]: |
1104926641 |
Last Name Of The Provider |
SUVAL |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1041 FREEDOM BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WATSONVILLE |
Zip Code Of The Provider |
950763263 |
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 |
18 |
Number Of Services |
1484 |
Number Of Medicare Beneficiaries |
448 |
Total Submitted Charge Amount |
363499 |
Total Medicare Allowed Amount |
152446.64 |
Total Medicare Payment Amount |
117377.23 |
Total Medicare Standardized Payment Amount |
115057 |
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 |
18 |
Number Of Medical Services |
1484 |
Number Of Medicare Beneficiaries With Medical Services |
448 |
Total Medical Submitted Charge Amount |
363499 |
Total Medical Medicare Allowed Amount |
152446.64 |
Total Medical Medicare Payment Amount |
117377.23 |
Total Medical Medicare Standardized Payment Amount |
115057 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
244 |
Number Of Male Beneficiaries |
204 |
Number Of Non Hispanic White Beneficiaries |
389 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
42 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
311 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
137 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.0522 |