National Provider Identifier [NPI]: |
1295960938 |
Last Name Of The Provider |
VAZ |
First Name Of The Provider |
VANESSA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8700 BEVERLY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST HOLLYWOOD |
Zip Code Of The Provider |
900481804 |
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 |
25 |
Number Of Services |
1341 |
Number Of Medicare Beneficiaries |
813 |
Total Submitted Charge Amount |
651636 |
Total Medicare Allowed Amount |
146344.3 |
Total Medicare Payment Amount |
112441.72 |
Total Medicare Standardized Payment Amount |
106533.16 |
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 |
25 |
Number Of Medical Services |
1341 |
Number Of Medicare Beneficiaries With Medical Services |
813 |
Total Medical Submitted Charge Amount |
651636 |
Total Medical Medicare Allowed Amount |
146344.3 |
Total Medical Medicare Payment Amount |
112441.72 |
Total Medical Medicare Standardized Payment Amount |
106533.16 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
185 |
Number Of Beneficiaries Age 65 to 74 |
236 |
Number Of Beneficiaries Age 75 to 84 |
217 |
Number Of Beneficiaries Age Greater 84 |
175 |
Number Of Female Beneficiaries |
428 |
Number Of Male Beneficiaries |
385 |
Number Of Non Hispanic White Beneficiaries |
496 |
Number Of Black or African American Beneficiaries |
165 |
Number Of AsianPacific Islander Beneficiaries |
44 |
Number Of Hispanic Beneficiaries |
84 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
425 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
388 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3803 |