National Provider Identifier [NPI]: |
1588633762 |
Last Name Of The Provider |
VALDEZ |
First Name Of The Provider |
VINCENT |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11411 BROOKSHIRE AVE |
Street Address 2 Of The Provider |
SUITE 205 |
City Of The Provider |
DOWNEY |
Zip Code Of The Provider |
902415003 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
3266 |
Number Of Medicare Beneficiaries |
658 |
Total Submitted Charge Amount |
1551452 |
Total Medicare Allowed Amount |
328951.01 |
Total Medicare Payment Amount |
251842.81 |
Total Medicare Standardized Payment Amount |
234765.42 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
295 |
Number Of Beneficiaries Age 65 to 74 |
184 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
415 |
Number Of Male Beneficiaries |
243 |
Number Of Non Hispanic White Beneficiaries |
303 |
Number Of Black or African American Beneficiaries |
163 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
172 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
236 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
422 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.7502 |