National Provider Identifier [NPI]: |
1851487573 |
Last Name Of The Provider |
BAYBAYAN |
First Name Of The Provider |
CARMEN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
86-260 FARRINGTON HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
WAIANAE |
Zip Code Of The Provider |
967923128 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
282 |
Number Of Medicare Beneficiaries |
72 |
Total Submitted Charge Amount |
27301.15 |
Total Medicare Allowed Amount |
22381.6 |
Total Medicare Payment Amount |
14742.34 |
Total Medicare Standardized Payment Amount |
13846.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
47 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
1993.64 |
Total Drug Medicare AllowedAmount |
1121.11 |
Total Drug Medicare PaymentAmount |
1098.71 |
Total Drug Medicare Standardized Payment Amount |
1098.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
235 |
Number Of Medicare Beneficiaries With Medical Services |
72 |
Total Medical Submitted Charge Amount |
25307.51 |
Total Medical Medicare Allowed Amount |
21260.49 |
Total Medical Medicare Payment Amount |
13643.63 |
Total Medical Medicare Standardized Payment Amount |
12747.43 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
33 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
59 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9734 |