National Provider Identifier [NPI]: |
1922185289 |
Last Name Of The Provider |
AQUITANIA |
First Name Of The Provider |
RAMONCITO |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8881 FLETCHER PARKWAY |
Street Address 2 Of The Provider |
#235 |
City Of The Provider |
LA MESA |
Zip Code Of The Provider |
919423188 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
923 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
212431 |
Total Medicare Allowed Amount |
155488.66 |
Total Medicare Payment Amount |
116133.11 |
Total Medicare Standardized Payment Amount |
113656.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
923 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
212431 |
Total Medical Medicare Allowed Amount |
155488.66 |
Total Medical Medicare Payment Amount |
116133.11 |
Total Medical Medicare Standardized Payment Amount |
113656.77 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
192 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
153 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.3482 |