National Provider Identifier [NPI]: |
1275523664 |
Last Name Of The Provider |
RANDOLPH |
First Name Of The Provider |
MARTINA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
271 TURN PIKE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FOLSOM |
Zip Code Of The Provider |
956308098 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
681 |
Number Of Medicare Beneficiaries |
178 |
Total Submitted Charge Amount |
91391 |
Total Medicare Allowed Amount |
51628.53 |
Total Medicare Payment Amount |
34961.82 |
Total Medicare Standardized Payment Amount |
33956.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
85 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
2755 |
Total Drug Medicare AllowedAmount |
1351.06 |
Total Drug Medicare PaymentAmount |
1310.16 |
Total Drug Medicare Standardized Payment Amount |
1310.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
596 |
Number Of Medicare Beneficiaries With Medical Services |
178 |
Total Medical Submitted Charge Amount |
88636 |
Total Medical Medicare Allowed Amount |
50277.47 |
Total Medical Medicare Payment Amount |
33651.66 |
Total Medical Medicare Standardized Payment Amount |
32646.82 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
43 |
Number Of Non Hispanic White Beneficiaries |
152 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
24 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8323 |