National Provider Identifier [NPI]: |
1912938861 |
Last Name Of The Provider |
DABIRI |
First Name Of The Provider |
AHMAD |
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 |
1100 WEST STEWART DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ORANGE |
Zip Code Of The Provider |
928683849 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pediatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
145 |
Number Of Medicare Beneficiaries |
74 |
Total Submitted Charge Amount |
16872 |
Total Medicare Allowed Amount |
8177.83 |
Total Medicare Payment Amount |
6356.22 |
Total Medicare Standardized Payment Amount |
5859.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
40 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
530 |
Total Drug Medicare AllowedAmount |
298.47 |
Total Drug Medicare PaymentAmount |
282 |
Total Drug Medicare Standardized Payment Amount |
282 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
105 |
Number Of Medicare Beneficiaries With Medical Services |
73 |
Total Medical Submitted Charge Amount |
16342 |
Total Medical Medicare Allowed Amount |
7879.36 |
Total Medical Medicare Payment Amount |
6074.22 |
Total Medical Medicare Standardized Payment Amount |
5577.62 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
51 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
63 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
16 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.974 |