National Provider Identifier [NPI]: |
1407852858 |
Last Name Of The Provider |
JOHL |
First Name Of The Provider |
JEWEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 TAYLOR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PLEASANT HILL |
Zip Code Of The Provider |
945232147 |
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 |
140 |
Number Of Services |
68839 |
Number Of Medicare Beneficiaries |
576 |
Total Submitted Charge Amount |
3860317 |
Total Medicare Allowed Amount |
1833911.29 |
Total Medicare Payment Amount |
1409712.83 |
Total Medicare Standardized Payment Amount |
1366032.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
55 |
Number Of Drug Services |
62956 |
Number Of Medicare Beneficiaries With Drug Services |
146 |
Total Drug Submitted ChargeAmount |
2707455 |
Total Drug Medicare AllowedAmount |
1278352.84 |
Total Drug Medicare PaymentAmount |
981989.55 |
Total Drug Medicare Standardized Payment Amount |
981989.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
85 |
Number Of Medical Services |
5883 |
Number Of Medicare Beneficiaries With Medical Services |
575 |
Total Medical Submitted Charge Amount |
1152862 |
Total Medical Medicare Allowed Amount |
555558.45 |
Total Medical Medicare Payment Amount |
427723.28 |
Total Medical Medicare Standardized Payment Amount |
384042.87 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
211 |
Number Of Beneficiaries Age 75 to 84 |
191 |
Number Of Beneficiaries Age Greater 84 |
125 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
294 |
Number Of Non Hispanic White Beneficiaries |
484 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
34 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
519 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
37 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.8757 |