National Provider Identifier [NPI]: |
1154541019 |
Last Name Of The Provider |
IRENE |
First Name Of The Provider |
SUNDAY |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
815 DR MARTIN LUTHER KING JR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BAKERSFIELD |
Zip Code Of The Provider |
933071365 |
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 |
61 |
Number Of Services |
618 |
Number Of Medicare Beneficiaries |
367 |
Total Submitted Charge Amount |
50936 |
Total Medicare Allowed Amount |
21545.45 |
Total Medicare Payment Amount |
15267.99 |
Total Medicare Standardized Payment Amount |
14448.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
191 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
1625 |
Total Drug Medicare AllowedAmount |
446.41 |
Total Drug Medicare PaymentAmount |
244.26 |
Total Drug Medicare Standardized Payment Amount |
244.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
427 |
Number Of Medicare Beneficiaries With Medical Services |
338 |
Total Medical Submitted Charge Amount |
49311 |
Total Medical Medicare Allowed Amount |
21099.04 |
Total Medical Medicare Payment Amount |
15023.73 |
Total Medical Medicare Standardized Payment Amount |
14204.5 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
147 |
Number Of Beneficiaries Age 65 to 74 |
177 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
258 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
51 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
264 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
44 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
323 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0753 |