National Provider Identifier [NPI]: |
1336183730 |
Last Name Of The Provider |
WINN |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5451 WALNUT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHINO |
Zip Code Of The Provider |
917102609 |
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 |
46 |
Number Of Services |
711 |
Number Of Medicare Beneficiaries |
341 |
Total Submitted Charge Amount |
275715 |
Total Medicare Allowed Amount |
64729.51 |
Total Medicare Payment Amount |
49769.46 |
Total Medicare Standardized Payment Amount |
49181.41 |
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 |
46 |
Number Of Medical Services |
711 |
Number Of Medicare Beneficiaries With Medical Services |
341 |
Total Medical Submitted Charge Amount |
275715 |
Total Medical Medicare Allowed Amount |
64729.51 |
Total Medical Medicare Payment Amount |
49769.46 |
Total Medical Medicare Standardized Payment Amount |
49181.41 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
180 |
Number Of Male Beneficiaries |
161 |
Number Of Non Hispanic White Beneficiaries |
154 |
Number Of Black or African American Beneficiaries |
34 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
121 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
239 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.532 |