National Provider Identifier [NPI]: |
1497799688 |
Last Name Of The Provider |
STARKS |
First Name Of The Provider |
WAYNE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
302 FRESNO ST |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937063600 |
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 |
74 |
Number Of Services |
4076 |
Number Of Medicare Beneficiaries |
475 |
Total Submitted Charge Amount |
496114 |
Total Medicare Allowed Amount |
428548.45 |
Total Medicare Payment Amount |
323631.36 |
Total Medicare Standardized Payment Amount |
306934.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
261 |
Number Of Medicare Beneficiaries With Drug Services |
168 |
Total Drug Submitted ChargeAmount |
3491 |
Total Drug Medicare AllowedAmount |
427.13 |
Total Drug Medicare PaymentAmount |
373.64 |
Total Drug Medicare Standardized Payment Amount |
373.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
3815 |
Number Of Medicare Beneficiaries With Medical Services |
475 |
Total Medical Submitted Charge Amount |
492623 |
Total Medical Medicare Allowed Amount |
428121.32 |
Total Medical Medicare Payment Amount |
323257.72 |
Total Medical Medicare Standardized Payment Amount |
306560.69 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
195 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
242 |
Number Of Male Beneficiaries |
233 |
Number Of Non Hispanic White Beneficiaries |
102 |
Number Of Black or African American Beneficiaries |
222 |
Number Of AsianPacific Islander Beneficiaries |
28 |
Number Of Hispanic Beneficiaries |
112 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
94 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
381 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
47 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.7632 |