National Provider Identifier [NPI]: |
1477512069 |
Last Name Of The Provider |
ROSENBERG |
First Name Of The Provider |
BRADLEY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
420 W ROWLAND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
COVINA |
Zip Code Of The Provider |
917232943 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
3422 |
Number Of Medicare Beneficiaries |
456 |
Total Submitted Charge Amount |
178365 |
Total Medicare Allowed Amount |
128526.79 |
Total Medicare Payment Amount |
95583.37 |
Total Medicare Standardized Payment Amount |
89493.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
2438 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
28995 |
Total Drug Medicare AllowedAmount |
14518.43 |
Total Drug Medicare PaymentAmount |
11383.46 |
Total Drug Medicare Standardized Payment Amount |
11383.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
984 |
Number Of Medicare Beneficiaries With Medical Services |
456 |
Total Medical Submitted Charge Amount |
149370 |
Total Medical Medicare Allowed Amount |
114008.36 |
Total Medical Medicare Payment Amount |
84199.91 |
Total Medical Medicare Standardized Payment Amount |
78109.76 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
152 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
231 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
37 |
Number Of Hispanic Beneficiaries |
158 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
255 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
201 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.1565 |