National Provider Identifier [NPI]: |
1215974969 |
Last Name Of The Provider |
CHAVEZ |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
23331 EL TORO RD |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
LAKE FOREST |
Zip Code Of The Provider |
926304891 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
71 |
Number Of Services |
16360 |
Number Of Medicare Beneficiaries |
443 |
Total Submitted Charge Amount |
662037.8 |
Total Medicare Allowed Amount |
410980.31 |
Total Medicare Payment Amount |
343339.41 |
Total Medicare Standardized Payment Amount |
332795.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
138 |
Number Of Medicare Beneficiaries With Drug Services |
72 |
Total Drug Submitted ChargeAmount |
3542 |
Total Drug Medicare AllowedAmount |
995.57 |
Total Drug Medicare PaymentAmount |
832.38 |
Total Drug Medicare Standardized Payment Amount |
832.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
16222 |
Number Of Medicare Beneficiaries With Medical Services |
443 |
Total Medical Submitted Charge Amount |
658495.8 |
Total Medical Medicare Allowed Amount |
409984.74 |
Total Medical Medicare Payment Amount |
342507.03 |
Total Medical Medicare Standardized Payment Amount |
331963.08 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
211 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
248 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
346 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
41 |
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
370 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6734 |