National Provider Identifier [NPI]: |
1164518593 |
Last Name Of The Provider |
HUTTON |
First Name Of The Provider |
KATHLEEN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1441 AVOCADO AVE |
Street Address 2 Of The Provider |
SUITE 309 |
City Of The Provider |
NEWPORT BEACH |
Zip Code Of The Provider |
92660 |
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 |
70 |
Number Of Services |
5168 |
Number Of Medicare Beneficiaries |
1011 |
Total Submitted Charge Amount |
421098 |
Total Medicare Allowed Amount |
327165.73 |
Total Medicare Payment Amount |
239255.28 |
Total Medicare Standardized Payment Amount |
213851.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
26 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
6490 |
Total Drug Medicare AllowedAmount |
6226.3 |
Total Drug Medicare PaymentAmount |
4881.36 |
Total Drug Medicare Standardized Payment Amount |
4881.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
5142 |
Number Of Medicare Beneficiaries With Medical Services |
1010 |
Total Medical Submitted Charge Amount |
414608 |
Total Medical Medicare Allowed Amount |
320939.43 |
Total Medical Medicare Payment Amount |
234373.92 |
Total Medical Medicare Standardized Payment Amount |
208970.6 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
562 |
Number Of Beneficiaries Age 75 to 84 |
315 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
677 |
Number Of Male Beneficiaries |
334 |
Number Of Non Hispanic White Beneficiaries |
963 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
16 |
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
990 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.907 |