National Provider Identifier [NPI]: |
1558346346 |
Last Name Of The Provider |
ELIAS |
First Name Of The Provider |
AFIF |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9900 STOCKDALE HWY |
Street Address 2 Of The Provider |
STE 203 |
City Of The Provider |
BAKERSFIELD |
Zip Code Of The Provider |
933113632 |
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 |
40 |
Number Of Services |
1249 |
Number Of Medicare Beneficiaries |
142 |
Total Submitted Charge Amount |
112525 |
Total Medicare Allowed Amount |
61599.64 |
Total Medicare Payment Amount |
42953.78 |
Total Medicare Standardized Payment Amount |
41271.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
168 |
Number Of Medicare Beneficiaries With Drug Services |
70 |
Total Drug Submitted ChargeAmount |
5435 |
Total Drug Medicare AllowedAmount |
1205.37 |
Total Drug Medicare PaymentAmount |
1097.96 |
Total Drug Medicare Standardized Payment Amount |
1097.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
1081 |
Number Of Medicare Beneficiaries With Medical Services |
142 |
Total Medical Submitted Charge Amount |
107090 |
Total Medical Medicare Allowed Amount |
60394.27 |
Total Medical Medicare Payment Amount |
41855.82 |
Total Medical Medicare Standardized Payment Amount |
40173.51 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
61 |
Number Of Non Hispanic White Beneficiaries |
105 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
98 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1171 |