National Provider Identifier [NPI]: |
1073569208 |
Last Name Of The Provider |
HAWKINS |
First Name Of The Provider |
RANDALL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
505 PARNASSUS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN FRANCISCO |
Zip Code Of The Provider |
941432204 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
586 |
Number Of Medicare Beneficiaries |
484 |
Total Submitted Charge Amount |
599946 |
Total Medicare Allowed Amount |
50382.96 |
Total Medicare Payment Amount |
37474.56 |
Total Medicare Standardized Payment Amount |
33526.02 |
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 |
41 |
Number Of Medical Services |
586 |
Number Of Medicare Beneficiaries With Medical Services |
484 |
Total Medical Submitted Charge Amount |
599946 |
Total Medical Medicare Allowed Amount |
50382.96 |
Total Medical Medicare Payment Amount |
37474.56 |
Total Medical Medicare Standardized Payment Amount |
33526.02 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
243 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
233 |
Number Of Male Beneficiaries |
251 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
49 |
Number Of AsianPacific Islander Beneficiaries |
76 |
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
284 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
200 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
33 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
2.1245 |