National Provider Identifier [NPI]: |
1841250719 |
Last Name Of The Provider |
FORSTHOFF |
First Name Of The Provider |
CYNTHIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2653 ELM AVE |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
LONG BEACH |
Zip Code Of The Provider |
908061652 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
4686 |
Number Of Medicare Beneficiaries |
128 |
Total Submitted Charge Amount |
286399.64 |
Total Medicare Allowed Amount |
155514.33 |
Total Medicare Payment Amount |
119656.14 |
Total Medicare Standardized Payment Amount |
115436.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
29 |
Number Of Drug Services |
4102 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
189749.64 |
Total Drug Medicare AllowedAmount |
106118.03 |
Total Drug Medicare PaymentAmount |
83196.67 |
Total Drug Medicare Standardized Payment Amount |
83196.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
584 |
Number Of Medicare Beneficiaries With Medical Services |
128 |
Total Medical Submitted Charge Amount |
96650 |
Total Medical Medicare Allowed Amount |
49396.3 |
Total Medical Medicare Payment Amount |
36459.47 |
Total Medical Medicare Standardized Payment Amount |
32239.43 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
16 |
Number Of Non Hispanic White Beneficiaries |
89 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
113 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
13 |
Percent Of With Cancer |
69 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3168 |