National Provider Identifier [NPI]: |
1821194440 |
Last Name Of The Provider |
MORTEN |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 EAST VALENCIA MESA DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FULLERTON |
Zip Code Of The Provider |
92835 |
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 |
146 |
Number Of Services |
4234 |
Number Of Medicare Beneficiaries |
2933 |
Total Submitted Charge Amount |
346973 |
Total Medicare Allowed Amount |
75059.82 |
Total Medicare Payment Amount |
54607.64 |
Total Medicare Standardized Payment Amount |
51016.78 |
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 |
146 |
Number Of Medical Services |
4234 |
Number Of Medicare Beneficiaries With Medical Services |
2933 |
Total Medical Submitted Charge Amount |
346973 |
Total Medical Medicare Allowed Amount |
75059.82 |
Total Medical Medicare Payment Amount |
54607.64 |
Total Medical Medicare Standardized Payment Amount |
51016.78 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
173 |
Number Of Beneficiaries Age 65 to 74 |
1142 |
Number Of Beneficiaries Age 75 to 84 |
1022 |
Number Of Beneficiaries Age Greater 84 |
596 |
Number Of Female Beneficiaries |
1758 |
Number Of Male Beneficiaries |
1175 |
Number Of Non Hispanic White Beneficiaries |
2246 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
274 |
Number Of Hispanic Beneficiaries |
302 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
65 |
Number Of Beneficiaries With Medicare Only Entitlement |
2468 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
465 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4479 |