National Provider Identifier [NPI]: |
1437120508 |
Last Name Of The Provider |
SCHULLER |
First Name Of The Provider |
JOERG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1775 3RD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATWATER |
Zip Code Of The Provider |
953013608 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
171 |
Number Of Services |
9101 |
Number Of Medicare Beneficiaries |
721 |
Total Submitted Charge Amount |
481509.6 |
Total Medicare Allowed Amount |
355074.91 |
Total Medicare Payment Amount |
259716.15 |
Total Medicare Standardized Payment Amount |
257217.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
24 |
Number Of Drug Services |
1804 |
Number Of Medicare Beneficiaries With Drug Services |
254 |
Total Drug Submitted ChargeAmount |
32160 |
Total Drug Medicare AllowedAmount |
19640.62 |
Total Drug Medicare PaymentAmount |
16166.75 |
Total Drug Medicare Standardized Payment Amount |
16166.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
147 |
Number Of Medical Services |
7297 |
Number Of Medicare Beneficiaries With Medical Services |
720 |
Total Medical Submitted Charge Amount |
449349.6 |
Total Medical Medicare Allowed Amount |
335434.29 |
Total Medical Medicare Payment Amount |
243549.4 |
Total Medical Medicare Standardized Payment Amount |
241050.62 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
287 |
Number Of Beneficiaries Age 75 to 84 |
250 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
413 |
Number Of Male Beneficiaries |
308 |
Number Of Non Hispanic White Beneficiaries |
511 |
Number Of Black or African American Beneficiaries |
32 |
Number Of AsianPacific Islander Beneficiaries |
23 |
Number Of Hispanic Beneficiaries |
134 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
596 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2307 |