National Provider Identifier [NPI]: |
1780730150 |
Last Name Of The Provider |
ROBINSON |
First Name Of The Provider |
JEHNI |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1520 SAN PABLO ST |
Street Address 2 Of The Provider |
SUITE 1300 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900335310 |
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 |
14 |
Number Of Services |
99 |
Number Of Medicare Beneficiaries |
54 |
Total Submitted Charge Amount |
16597 |
Total Medicare Allowed Amount |
7987.29 |
Total Medicare Payment Amount |
6273.82 |
Total Medicare Standardized Payment Amount |
5992.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
13 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
625 |
Total Drug Medicare AllowedAmount |
512.45 |
Total Drug Medicare PaymentAmount |
502.17 |
Total Drug Medicare Standardized Payment Amount |
502.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
86 |
Number Of Medicare Beneficiaries With Medical Services |
54 |
Total Medical Submitted Charge Amount |
15972 |
Total Medical Medicare Allowed Amount |
7474.84 |
Total Medical Medicare Payment Amount |
5771.65 |
Total Medical Medicare Standardized Payment Amount |
5490.57 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
20 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
26 |
Number Of Male Beneficiaries |
28 |
Number Of Non Hispanic White Beneficiaries |
18 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
23 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
20 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.4363 |