National Provider Identifier [NPI]: |
1528171113 |
Last Name Of The Provider |
HEDAYA |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
272 BENEDICT AVE |
Street Address 2 Of The Provider |
3RD FLOOR RUSE |
City Of The Provider |
NORWALK |
Zip Code Of The Provider |
448572374 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
4181 |
Number Of Medicare Beneficiaries |
498 |
Total Submitted Charge Amount |
612622.12 |
Total Medicare Allowed Amount |
332576.54 |
Total Medicare Payment Amount |
248613.56 |
Total Medicare Standardized Payment Amount |
236194.73 |
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 |
51 |
Number Of Medical Services |
4181 |
Number Of Medicare Beneficiaries With Medical Services |
498 |
Total Medical Submitted Charge Amount |
612622.12 |
Total Medical Medicare Allowed Amount |
332576.54 |
Total Medical Medicare Payment Amount |
248613.56 |
Total Medical Medicare Standardized Payment Amount |
236194.73 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
183 |
Number Of Beneficiaries Age 65 to 74 |
172 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
322 |
Number Of Male Beneficiaries |
176 |
Number Of Non Hispanic White Beneficiaries |
443 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
330 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4966 |