National Provider Identifier [NPI]: |
1861418436 |
Last Name Of The Provider |
KIA |
First Name Of The Provider |
ALI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2470 E FLAMINGO RD |
Street Address 2 Of The Provider |
SUITE D |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891215200 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
2829 |
Number Of Medicare Beneficiaries |
460 |
Total Submitted Charge Amount |
609900 |
Total Medicare Allowed Amount |
318077.03 |
Total Medicare Payment Amount |
248546.22 |
Total Medicare Standardized Payment Amount |
243664.85 |
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 |
11 |
Number Of Medical Services |
2829 |
Number Of Medicare Beneficiaries With Medical Services |
460 |
Total Medical Submitted Charge Amount |
609900 |
Total Medical Medicare Allowed Amount |
318077.03 |
Total Medical Medicare Payment Amount |
248546.22 |
Total Medical Medicare Standardized Payment Amount |
243664.85 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
132 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
247 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
69 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
72 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
274 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
186 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.6026 |