National Provider Identifier [NPI]: |
1396859393 |
Last Name Of The Provider |
HARRIS |
First Name Of The Provider |
ABDUL |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1701 4TH ST |
Street Address 2 Of The Provider |
STE 200 |
City Of The Provider |
SANTA ROSA |
Zip Code Of The Provider |
954043601 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
864 |
Number Of Medicare Beneficiaries |
506 |
Total Submitted Charge Amount |
426845 |
Total Medicare Allowed Amount |
176948.13 |
Total Medicare Payment Amount |
137075.8 |
Total Medicare Standardized Payment Amount |
135655.86 |
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 |
85 |
Number Of Medical Services |
864 |
Number Of Medicare Beneficiaries With Medical Services |
506 |
Total Medical Submitted Charge Amount |
426845 |
Total Medical Medicare Allowed Amount |
176948.13 |
Total Medical Medicare Payment Amount |
137075.8 |
Total Medical Medicare Standardized Payment Amount |
135655.86 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
101 |
Number Of Female Beneficiaries |
243 |
Number Of Male Beneficiaries |
263 |
Number Of Non Hispanic White Beneficiaries |
447 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
346 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
160 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.6967 |