| National Provider Identifier [NPI]: | 1811207632 |
| Last Name Of The Provider | HAIMANOT |
| First Name Of The Provider | BEKELE |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9528 LOS COCHES COURT |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIVERSIDE |
| Zip Code Of The Provider | 92508 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 5484 |
| Number Of Medicare Beneficiaries | 346 |
| Total Submitted Charge Amount | 826251.08 |
| Total Medicare Allowed Amount | 626478.65 |
| Total Medicare Payment Amount | 489688.36 |
| Total Medicare Standardized Payment Amount | 515802.44 |
| 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 | 20 |
| Number Of Medical Services | 5484 |
| Number Of Medicare Beneficiaries With Medical Services | 346 |
| Total Medical Submitted Charge Amount | 826251.08 |
| Total Medical Medicare Allowed Amount | 626478.65 |
| Total Medical Medicare Payment Amount | 489688.36 |
| Total Medical Medicare Standardized Payment Amount | 515802.44 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 108 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 193 |
| Number Of Male Beneficiaries | 153 |
| Number Of Non Hispanic White Beneficiaries | 118 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 133 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 17 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 329 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 67 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 67 |
| Percent Of With Chronic Kidney Disease | 72 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 52 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 27 |
| Percent Of With Stroke | 32 |
| Average HCC Risk Score Of Beneficiaries | 6.0205 |