National Provider Identifier [NPI]: |
1205918588 |
Last Name Of The Provider |
LINE |
First Name Of The Provider |
WARREN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
191 S BUENA VISTA ST |
Street Address 2 Of The Provider |
SUITE #320 |
City Of The Provider |
BURBANK |
Zip Code Of The Provider |
915054554 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
5213 |
Number Of Medicare Beneficiaries |
1814 |
Total Submitted Charge Amount |
597136 |
Total Medicare Allowed Amount |
407919.71 |
Total Medicare Payment Amount |
284979.17 |
Total Medicare Standardized Payment Amount |
262912.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
376 |
Number Of Medicare Beneficiaries With Drug Services |
288 |
Total Drug Submitted ChargeAmount |
9500 |
Total Drug Medicare AllowedAmount |
1534.39 |
Total Drug Medicare PaymentAmount |
1002.34 |
Total Drug Medicare Standardized Payment Amount |
1002.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
4837 |
Number Of Medicare Beneficiaries With Medical Services |
1808 |
Total Medical Submitted Charge Amount |
587636 |
Total Medical Medicare Allowed Amount |
406385.32 |
Total Medical Medicare Payment Amount |
283976.83 |
Total Medical Medicare Standardized Payment Amount |
261910.5 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
738 |
Number Of Beneficiaries Age 75 to 84 |
586 |
Number Of Beneficiaries Age Greater 84 |
386 |
Number Of Female Beneficiaries |
1041 |
Number Of Male Beneficiaries |
773 |
Number Of Non Hispanic White Beneficiaries |
1569 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
43 |
Number Of Hispanic Beneficiaries |
140 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
35 |
Number Of Beneficiaries With Medicare Only Entitlement |
1644 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
170 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1801 |