National Provider Identifier [NPI]: |
1134209000 |
Last Name Of The Provider |
QUINTO |
First Name Of The Provider |
ERNESTO |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3939 J ST |
Street Address 2 Of The Provider |
STE. 370 |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958193631 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
2920 |
Number Of Medicare Beneficiaries |
1004 |
Total Submitted Charge Amount |
326649 |
Total Medicare Allowed Amount |
273309.83 |
Total Medicare Payment Amount |
194643.99 |
Total Medicare Standardized Payment Amount |
198507.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
139 |
Number Of Medicare Beneficiaries With Drug Services |
104 |
Total Drug Submitted ChargeAmount |
5574 |
Total Drug Medicare AllowedAmount |
3515.07 |
Total Drug Medicare PaymentAmount |
3433.25 |
Total Drug Medicare Standardized Payment Amount |
3433.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
2781 |
Number Of Medicare Beneficiaries With Medical Services |
1002 |
Total Medical Submitted Charge Amount |
321075 |
Total Medical Medicare Allowed Amount |
269794.76 |
Total Medical Medicare Payment Amount |
191210.74 |
Total Medical Medicare Standardized Payment Amount |
195074.01 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
270 |
Number Of Beneficiaries Age 75 to 84 |
291 |
Number Of Beneficiaries Age Greater 84 |
317 |
Number Of Female Beneficiaries |
629 |
Number Of Male Beneficiaries |
375 |
Number Of Non Hispanic White Beneficiaries |
694 |
Number Of Black or African American Beneficiaries |
86 |
Number Of AsianPacific Islander Beneficiaries |
85 |
Number Of Hispanic Beneficiaries |
119 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
545 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
459 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.7274 |