National Provider Identifier [NPI]: |
1215033808 |
Last Name Of The Provider |
MAPLES |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3771 KATELLA AVE |
Street Address 2 Of The Provider |
SUITE 110 |
City Of The Provider |
LOS ALAMITOS |
Zip Code Of The Provider |
907203108 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
958 |
Number Of Medicare Beneficiaries |
138 |
Total Submitted Charge Amount |
76536 |
Total Medicare Allowed Amount |
59196.23 |
Total Medicare Payment Amount |
43482.13 |
Total Medicare Standardized Payment Amount |
39490.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
183 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
5912 |
Total Drug Medicare AllowedAmount |
1378.02 |
Total Drug Medicare PaymentAmount |
1245.33 |
Total Drug Medicare Standardized Payment Amount |
1245.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
775 |
Number Of Medicare Beneficiaries With Medical Services |
138 |
Total Medical Submitted Charge Amount |
70624 |
Total Medical Medicare Allowed Amount |
57818.21 |
Total Medical Medicare Payment Amount |
42236.8 |
Total Medical Medicare Standardized Payment Amount |
38244.95 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
76 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
107 |
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 |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0037 |