National Provider Identifier [NPI]: |
1790739191 |
Last Name Of The Provider |
GOLUBEVA-GANELES |
First Name Of The Provider |
ARINA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5 HARRIS CT # 201 |
Street Address 2 Of The Provider |
BLDG T, 2ND FLR |
City Of The Provider |
MONTEREY |
Zip Code Of The Provider |
939405750 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
112 |
Number Of Services |
173755 |
Number Of Medicare Beneficiaries |
500 |
Total Submitted Charge Amount |
3832139.31 |
Total Medicare Allowed Amount |
1736323.8 |
Total Medicare Payment Amount |
1335941.69 |
Total Medicare Standardized Payment Amount |
1317959.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
65 |
Number Of Drug Services |
167055 |
Number Of Medicare Beneficiaries With Drug Services |
259 |
Total Drug Submitted ChargeAmount |
3017403.51 |
Total Drug Medicare AllowedAmount |
1389937.74 |
Total Drug Medicare PaymentAmount |
1071440.87 |
Total Drug Medicare Standardized Payment Amount |
1071440.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
6700 |
Number Of Medicare Beneficiaries With Medical Services |
497 |
Total Medical Submitted Charge Amount |
814735.8 |
Total Medical Medicare Allowed Amount |
346386.06 |
Total Medical Medicare Payment Amount |
264500.82 |
Total Medical Medicare Standardized Payment Amount |
246518.8 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
208 |
Number Of Beneficiaries Age 75 to 84 |
158 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
129 |
Number Of Non Hispanic White Beneficiaries |
383 |
Number Of Black or African American Beneficiaries |
38 |
Number Of AsianPacific Islander Beneficiaries |
29 |
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
431 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
46 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.509 |