National Provider Identifier [NPI]: |
1194800169 |
Last Name Of The Provider |
DELUCA |
First Name Of The Provider |
JOSEPH |
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 |
4615 E TALMADGE DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
92116 |
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 |
10 |
Number Of Services |
955 |
Number Of Medicare Beneficiaries |
125 |
Total Submitted Charge Amount |
88670 |
Total Medicare Allowed Amount |
70383.13 |
Total Medicare Payment Amount |
51799.74 |
Total Medicare Standardized Payment Amount |
51330.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
18 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
900 |
Total Drug Medicare AllowedAmount |
216.72 |
Total Drug Medicare PaymentAmount |
212.4 |
Total Drug Medicare Standardized Payment Amount |
212.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
9 |
Number Of Medical Services |
937 |
Number Of Medicare Beneficiaries With Medical Services |
125 |
Total Medical Submitted Charge Amount |
87770 |
Total Medical Medicare Allowed Amount |
70166.41 |
Total Medical Medicare Payment Amount |
51587.34 |
Total Medical Medicare Standardized Payment Amount |
51118.08 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
96 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
14 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
52 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
75 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.0686 |