National Provider Identifier [NPI]: |
1881610095 |
Last Name Of The Provider |
FORD |
First Name Of The Provider |
SCOTT |
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 |
2577 HERNDON ST. |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLOVIS |
Zip Code Of The Provider |
936116800 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1019 |
Number Of Medicare Beneficiaries |
869 |
Total Submitted Charge Amount |
565454 |
Total Medicare Allowed Amount |
164384.65 |
Total Medicare Payment Amount |
126968.95 |
Total Medicare Standardized Payment Amount |
125650.72 |
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 |
36 |
Number Of Medical Services |
1019 |
Number Of Medicare Beneficiaries With Medical Services |
869 |
Total Medical Submitted Charge Amount |
565454 |
Total Medical Medicare Allowed Amount |
164384.65 |
Total Medical Medicare Payment Amount |
126968.95 |
Total Medical Medicare Standardized Payment Amount |
125650.72 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
165 |
Number Of Beneficiaries Age 65 to 74 |
248 |
Number Of Beneficiaries Age 75 to 84 |
235 |
Number Of Beneficiaries Age Greater 84 |
221 |
Number Of Female Beneficiaries |
536 |
Number Of Male Beneficiaries |
333 |
Number Of Non Hispanic White Beneficiaries |
573 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
62 |
Number Of Hispanic Beneficiaries |
186 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
496 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
373 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8362 |