National Provider Identifier [NPI]: |
1629150396 |
Last Name Of The Provider |
HODGE |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1440 N HARBOR BLVD STE 300 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FULLERTON |
Zip Code Of The Provider |
928354116 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
4091 |
Number Of Medicare Beneficiaries |
603 |
Total Submitted Charge Amount |
534256 |
Total Medicare Allowed Amount |
326102.76 |
Total Medicare Payment Amount |
241781.07 |
Total Medicare Standardized Payment Amount |
213911.61 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
263 |
Number Of Beneficiaries Age 75 to 84 |
214 |
Number Of Beneficiaries Age Greater 84 |
113 |
Number Of Female Beneficiaries |
355 |
Number Of Male Beneficiaries |
248 |
Number Of Non Hispanic White Beneficiaries |
551 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0624 |