National Provider Identifier [NPI]: |
1649317322 |
Last Name Of The Provider |
SILAO |
First Name Of The Provider |
SAMUEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2557 CHINO HILLS PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHINO HILLS |
Zip Code Of The Provider |
917095103 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
2991 |
Number Of Medicare Beneficiaries |
287 |
Total Submitted Charge Amount |
439295 |
Total Medicare Allowed Amount |
319846.94 |
Total Medicare Payment Amount |
243083.66 |
Total Medicare Standardized Payment Amount |
240753.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
40 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
920 |
Total Drug Medicare AllowedAmount |
319.29 |
Total Drug Medicare PaymentAmount |
282.03 |
Total Drug Medicare Standardized Payment Amount |
282.03 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
2951 |
Number Of Medicare Beneficiaries With Medical Services |
287 |
Total Medical Submitted Charge Amount |
438375 |
Total Medical Medicare Allowed Amount |
319527.65 |
Total Medical Medicare Payment Amount |
242801.63 |
Total Medical Medicare Standardized Payment Amount |
240471.43 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
107 |
Number Of Black or African American Beneficiaries |
37 |
Number Of AsianPacific Islander Beneficiaries |
29 |
Number Of Hispanic Beneficiaries |
103 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
112 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
175 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.5396 |