National Provider Identifier [NPI]: |
1851497911 |
Last Name Of The Provider |
GONZALEZ |
First Name Of The Provider |
CASIMIRO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4566 FLORENCE AVE |
Street Address 2 Of The Provider |
#3 |
City Of The Provider |
CUDAHY |
Zip Code Of The Provider |
902014345 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
3889 |
Number Of Medicare Beneficiaries |
801 |
Total Submitted Charge Amount |
1133335 |
Total Medicare Allowed Amount |
503138.13 |
Total Medicare Payment Amount |
372915.27 |
Total Medicare Standardized Payment Amount |
337570.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
293 |
Number Of Medicare Beneficiaries With Drug Services |
54 |
Total Drug Submitted ChargeAmount |
23450 |
Total Drug Medicare AllowedAmount |
7899.55 |
Total Drug Medicare PaymentAmount |
6133.69 |
Total Drug Medicare Standardized Payment Amount |
6133.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
3596 |
Number Of Medicare Beneficiaries With Medical Services |
801 |
Total Medical Submitted Charge Amount |
1109885 |
Total Medical Medicare Allowed Amount |
495238.58 |
Total Medical Medicare Payment Amount |
366781.58 |
Total Medical Medicare Standardized Payment Amount |
331436.42 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
364 |
Number Of Beneficiaries Age 75 to 84 |
235 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
503 |
Number Of Male Beneficiaries |
298 |
Number Of Non Hispanic White Beneficiaries |
24 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
765 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
78 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
723 |
Percent Of With Atrial Fibrillation |
3 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.6088 |