National Provider Identifier [NPI]: |
1831146240 |
Last Name Of The Provider |
HOLLAND |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1115 S SUNSET AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST COVINA |
Zip Code Of The Provider |
917903940 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
370 |
Number Of Medicare Beneficiaries |
287 |
Total Submitted Charge Amount |
510485 |
Total Medicare Allowed Amount |
54304.84 |
Total Medicare Payment Amount |
40557.38 |
Total Medicare Standardized Payment Amount |
38687.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
370 |
Number Of Medicare Beneficiaries With Medical Services |
287 |
Total Medical Submitted Charge Amount |
510485 |
Total Medical Medicare Allowed Amount |
54304.84 |
Total Medical Medicare Payment Amount |
40557.38 |
Total Medical Medicare Standardized Payment Amount |
38687.12 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
59 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
42 |
Number Of Hispanic Beneficiaries |
164 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
63 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
224 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.912 |