National Provider Identifier [NPI]: |
1619968443 |
Last Name Of The Provider |
KNIGHT |
First Name Of The Provider |
SUE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 PORTER DR |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
SAN RAMON |
Zip Code Of The Provider |
945831587 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
640 |
Number Of Medicare Beneficiaries |
203 |
Total Submitted Charge Amount |
37847.74 |
Total Medicare Allowed Amount |
32898.51 |
Total Medicare Payment Amount |
26312.69 |
Total Medicare Standardized Payment Amount |
23439.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
198 |
Number Of Medicare Beneficiaries With Drug Services |
123 |
Total Drug Submitted ChargeAmount |
6513 |
Total Drug Medicare AllowedAmount |
4272.37 |
Total Drug Medicare PaymentAmount |
4135.48 |
Total Drug Medicare Standardized Payment Amount |
4135.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
442 |
Number Of Medicare Beneficiaries With Medical Services |
199 |
Total Medical Submitted Charge Amount |
31334.74 |
Total Medical Medicare Allowed Amount |
28626.14 |
Total Medical Medicare Payment Amount |
22177.21 |
Total Medical Medicare Standardized Payment Amount |
19304.29 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
126 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
170 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
20 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
5 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
13 |
Percent Of With Diabetes |
13 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.738 |