National Provider Identifier [NPI]: |
1629019930 |
Last Name Of The Provider |
MALLEY |
First Name Of The Provider |
NATALYA |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4770 W HERNDON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937228402 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
6532 |
Number Of Medicare Beneficiaries |
657 |
Total Submitted Charge Amount |
538796 |
Total Medicare Allowed Amount |
296920.11 |
Total Medicare Payment Amount |
234273.33 |
Total Medicare Standardized Payment Amount |
228895.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
577 |
Number Of Medicare Beneficiaries With Drug Services |
339 |
Total Drug Submitted ChargeAmount |
42553 |
Total Drug Medicare AllowedAmount |
27204.65 |
Total Drug Medicare PaymentAmount |
26383.19 |
Total Drug Medicare Standardized Payment Amount |
26383.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
5955 |
Number Of Medicare Beneficiaries With Medical Services |
657 |
Total Medical Submitted Charge Amount |
496243 |
Total Medical Medicare Allowed Amount |
269715.46 |
Total Medical Medicare Payment Amount |
207890.14 |
Total Medical Medicare Standardized Payment Amount |
202512.63 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
315 |
Number Of Beneficiaries Age 75 to 84 |
166 |
Number Of Beneficiaries Age Greater 84 |
128 |
Number Of Female Beneficiaries |
501 |
Number Of Male Beneficiaries |
156 |
Number Of Non Hispanic White Beneficiaries |
507 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
95 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
575 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
82 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1195 |