National Provider Identifier [NPI]: |
1427034560 |
Last Name Of The Provider |
LEDERHAUS |
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 |
255 E BONITA AVE |
Street Address 2 Of The Provider |
BUILDING #9 |
City Of The Provider |
POMONA |
Zip Code Of The Provider |
917671923 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurosurgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
72 |
Number Of Services |
826 |
Number Of Medicare Beneficiaries |
244 |
Total Submitted Charge Amount |
536809.1 |
Total Medicare Allowed Amount |
170379.45 |
Total Medicare Payment Amount |
130363.81 |
Total Medicare Standardized Payment Amount |
123111.95 |
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 |
72 |
Number Of Medical Services |
826 |
Number Of Medicare Beneficiaries With Medical Services |
244 |
Total Medical Submitted Charge Amount |
536809.1 |
Total Medical Medicare Allowed Amount |
170379.45 |
Total Medical Medicare Payment Amount |
130363.81 |
Total Medical Medicare Standardized Payment Amount |
123111.95 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
164 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
164 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
1.8331 |