National Provider Identifier [NPI]: |
1871591727 |
Last Name Of The Provider |
BOYD |
First Name Of The Provider |
WAYNE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
399 E 21ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN BERNARDINO |
Zip Code Of The Provider |
924044815 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
141 |
Number Of Services |
3160 |
Number Of Medicare Beneficiaries |
1780 |
Total Submitted Charge Amount |
636581.48 |
Total Medicare Allowed Amount |
213131.25 |
Total Medicare Payment Amount |
165553.05 |
Total Medicare Standardized Payment Amount |
156061.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
160 |
Number Of Medicare Beneficiaries With Drug Services |
72 |
Total Drug Submitted ChargeAmount |
4276 |
Total Drug Medicare AllowedAmount |
759.07 |
Total Drug Medicare PaymentAmount |
579.73 |
Total Drug Medicare Standardized Payment Amount |
579.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
139 |
Number Of Medical Services |
3000 |
Number Of Medicare Beneficiaries With Medical Services |
1780 |
Total Medical Submitted Charge Amount |
632305.48 |
Total Medical Medicare Allowed Amount |
212372.18 |
Total Medical Medicare Payment Amount |
164973.32 |
Total Medical Medicare Standardized Payment Amount |
155482.17 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
343 |
Number Of Beneficiaries Age 65 to 74 |
765 |
Number Of Beneficiaries Age 75 to 84 |
490 |
Number Of Beneficiaries Age Greater 84 |
182 |
Number Of Female Beneficiaries |
1274 |
Number Of Male Beneficiaries |
506 |
Number Of Non Hispanic White Beneficiaries |
617 |
Number Of Black or African American Beneficiaries |
235 |
Number Of AsianPacific Islander Beneficiaries |
146 |
Number Of Hispanic Beneficiaries |
750 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
703 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1077 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.3757 |