National Provider Identifier [NPI]: |
1194935932 |
Last Name Of The Provider |
LIN |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1661 SOQUEL DR |
Street Address 2 Of The Provider |
BLDG G |
City Of The Provider |
SANTA CRUZ |
Zip Code Of The Provider |
950651709 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
170 |
Number Of Services |
19858 |
Number Of Medicare Beneficiaries |
2719 |
Total Submitted Charge Amount |
1420438.12 |
Total Medicare Allowed Amount |
374891.89 |
Total Medicare Payment Amount |
286679.3 |
Total Medicare Standardized Payment Amount |
277423.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
15558 |
Number Of Medicare Beneficiaries With Drug Services |
189 |
Total Drug Submitted ChargeAmount |
13586.9 |
Total Drug Medicare AllowedAmount |
4470.31 |
Total Drug Medicare PaymentAmount |
3471.7 |
Total Drug Medicare Standardized Payment Amount |
3471.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
167 |
Number Of Medical Services |
4300 |
Number Of Medicare Beneficiaries With Medical Services |
2718 |
Total Medical Submitted Charge Amount |
1406851.22 |
Total Medical Medicare Allowed Amount |
370421.58 |
Total Medical Medicare Payment Amount |
283207.6 |
Total Medical Medicare Standardized Payment Amount |
273951.74 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
467 |
Number Of Beneficiaries Age 65 to 74 |
1078 |
Number Of Beneficiaries Age 75 to 84 |
746 |
Number Of Beneficiaries Age Greater 84 |
428 |
Number Of Female Beneficiaries |
1613 |
Number Of Male Beneficiaries |
1106 |
Number Of Non Hispanic White Beneficiaries |
1776 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
75 |
Number Of Hispanic Beneficiaries |
795 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
42 |
Number Of Beneficiaries With Medicare Only Entitlement |
1745 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
974 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4183 |