National Provider Identifier [NPI]: |
1922280916 |
Last Name Of The Provider |
TARABAR |
First Name Of The Provider |
AMERISA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1450 CHAPEL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW HAVEN |
Zip Code Of The Provider |
06511 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
434 |
Number Of Medicare Beneficiaries |
196 |
Total Submitted Charge Amount |
103090 |
Total Medicare Allowed Amount |
40239.44 |
Total Medicare Payment Amount |
30984.02 |
Total Medicare Standardized Payment Amount |
29343.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
21 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
958 |
Total Drug Medicare AllowedAmount |
423.6 |
Total Drug Medicare PaymentAmount |
415.16 |
Total Drug Medicare Standardized Payment Amount |
415.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
413 |
Number Of Medicare Beneficiaries With Medical Services |
196 |
Total Medical Submitted Charge Amount |
102132 |
Total Medical Medicare Allowed Amount |
39815.84 |
Total Medical Medicare Payment Amount |
30568.86 |
Total Medical Medicare Standardized Payment Amount |
28928.77 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
117 |
Number Of Black or African American Beneficiaries |
46 |
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 |
75 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
121 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.2954 |