National Provider Identifier [NPI]: |
1215962402 |
Last Name Of The Provider |
HEALEY |
First Name Of The Provider |
PATRICK |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3626 RUFFIN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921231810 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
171 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
176148 |
Total Medicare Allowed Amount |
43167.23 |
Total Medicare Payment Amount |
33346.08 |
Total Medicare Standardized Payment Amount |
33819.25 |
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 |
61 |
Number Of Medical Services |
171 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
176148 |
Total Medical Medicare Allowed Amount |
43167.23 |
Total Medical Medicare Payment Amount |
33346.08 |
Total Medical Medicare Standardized Payment Amount |
33819.25 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
82 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
92 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
|
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.4088 |