National Provider Identifier [NPI]: |
1902937956 |
Last Name Of The Provider |
SALAZAR |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
P.A.-C. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2100 POWELL ST STE 900 |
Street Address 2 Of The Provider |
|
City Of The Provider |
EMERYVILLE |
Zip Code Of The Provider |
946081844 |
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 |
59 |
Number Of Services |
644 |
Number Of Medicare Beneficiaries |
322 |
Total Submitted Charge Amount |
180971 |
Total Medicare Allowed Amount |
57701.52 |
Total Medicare Payment Amount |
44009.42 |
Total Medicare Standardized Payment Amount |
41554.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
104 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
430 |
Total Drug Medicare AllowedAmount |
34.91 |
Total Drug Medicare PaymentAmount |
27.42 |
Total Drug Medicare Standardized Payment Amount |
27.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
540 |
Number Of Medicare Beneficiaries With Medical Services |
322 |
Total Medical Submitted Charge Amount |
180541 |
Total Medical Medicare Allowed Amount |
57666.61 |
Total Medical Medicare Payment Amount |
43982 |
Total Medical Medicare Standardized Payment Amount |
41527.26 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
59 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
213 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6557 |