National Provider Identifier [NPI]: |
1912968496 |
Last Name Of The Provider |
GALLEMORE |
First Name Of The Provider |
RON |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4201 TORRANCE BLVD |
Street Address 2 Of The Provider |
220 |
City Of The Provider |
TORRANCE |
Zip Code Of The Provider |
905034504 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
56323 |
Number Of Medicare Beneficiaries |
2542 |
Total Submitted Charge Amount |
12748686.21 |
Total Medicare Allowed Amount |
6719934.41 |
Total Medicare Payment Amount |
5207902.46 |
Total Medicare Standardized Payment Amount |
4907514.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
18529 |
Number Of Medicare Beneficiaries With Drug Services |
892 |
Total Drug Submitted ChargeAmount |
4311725.51 |
Total Drug Medicare AllowedAmount |
2910949.58 |
Total Drug Medicare PaymentAmount |
2278867.04 |
Total Drug Medicare Standardized Payment Amount |
2278867.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
37794 |
Number Of Medicare Beneficiaries With Medical Services |
2541 |
Total Medical Submitted Charge Amount |
8436960.7 |
Total Medical Medicare Allowed Amount |
3808984.83 |
Total Medical Medicare Payment Amount |
2929035.42 |
Total Medical Medicare Standardized Payment Amount |
2628647.76 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
264 |
Number Of Beneficiaries Age 65 to 74 |
1073 |
Number Of Beneficiaries Age 75 to 84 |
787 |
Number Of Beneficiaries Age Greater 84 |
418 |
Number Of Female Beneficiaries |
1417 |
Number Of Male Beneficiaries |
1125 |
Number Of Non Hispanic White Beneficiaries |
1458 |
Number Of Black or African American Beneficiaries |
216 |
Number Of AsianPacific Islander Beneficiaries |
238 |
Number Of Hispanic Beneficiaries |
552 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
78 |
Number Of Beneficiaries With Medicare Only Entitlement |
1694 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
848 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.5904 |