National Provider Identifier [NPI]: |
1558327106 |
Last Name Of The Provider |
VANDERSCHELDEN |
First Name Of The Provider |
PHILIPPE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1867 E FIR AVE |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937203841 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
169 |
Number Of Services |
29655 |
Number Of Medicare Beneficiaries |
4241 |
Total Submitted Charge Amount |
3018614 |
Total Medicare Allowed Amount |
554881.65 |
Total Medicare Payment Amount |
417146.01 |
Total Medicare Standardized Payment Amount |
407837.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
23487 |
Number Of Medicare Beneficiaries With Drug Services |
398 |
Total Drug Submitted ChargeAmount |
26022 |
Total Drug Medicare AllowedAmount |
8562.96 |
Total Drug Medicare PaymentAmount |
6584.51 |
Total Drug Medicare Standardized Payment Amount |
6584.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
158 |
Number Of Medical Services |
6168 |
Number Of Medicare Beneficiaries With Medical Services |
4240 |
Total Medical Submitted Charge Amount |
2992592 |
Total Medical Medicare Allowed Amount |
546318.69 |
Total Medical Medicare Payment Amount |
410561.5 |
Total Medical Medicare Standardized Payment Amount |
401252.9 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
787 |
Number Of Beneficiaries Age 65 to 74 |
1561 |
Number Of Beneficiaries Age 75 to 84 |
1183 |
Number Of Beneficiaries Age Greater 84 |
710 |
Number Of Female Beneficiaries |
2441 |
Number Of Male Beneficiaries |
1800 |
Number Of Non Hispanic White Beneficiaries |
2484 |
Number Of Black or African American Beneficiaries |
275 |
Number Of AsianPacific Islander Beneficiaries |
324 |
Number Of Hispanic Beneficiaries |
1074 |
Number Of American Indian Alaska Native Beneficiaries |
33 |
Number Of Beneficiaries With Race Not Else where Classified |
51 |
Number Of Beneficiaries With Medicare Only Entitlement |
2353 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1888 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.8882 |