National Provider Identifier [NPI]: |
1558529479 |
Last Name Of The Provider |
PRESTON |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2405 SHADELANDS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WALNUT CREEK |
Zip Code Of The Provider |
945982444 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
71 |
Number Of Services |
977 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
199272.75 |
Total Medicare Allowed Amount |
81387.23 |
Total Medicare Payment Amount |
59665.49 |
Total Medicare Standardized Payment Amount |
55415.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
323 |
Number Of Medicare Beneficiaries With Drug Services |
54 |
Total Drug Submitted ChargeAmount |
2852 |
Total Drug Medicare AllowedAmount |
1550.64 |
Total Drug Medicare PaymentAmount |
1184.69 |
Total Drug Medicare Standardized Payment Amount |
1184.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
654 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
196420.75 |
Total Medical Medicare Allowed Amount |
79836.59 |
Total Medical Medicare Payment Amount |
58480.8 |
Total Medical Medicare Standardized Payment Amount |
54230.86 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
173 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
190 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2641 |