National Provider Identifier [NPI]: |
1487682084 |
Last Name Of The Provider |
RAZZOUK |
First Name Of The Provider |
ANEES |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11370 ANDERSON ST |
Street Address 2 Of The Provider |
SUITE 2100 |
City Of The Provider |
LOMA LINDA |
Zip Code Of The Provider |
923543450 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Thoracic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
230 |
Number Of Medicare Beneficiaries |
111 |
Total Submitted Charge Amount |
548394.19 |
Total Medicare Allowed Amount |
158535.11 |
Total Medicare Payment Amount |
123832.55 |
Total Medicare Standardized Payment Amount |
126503.55 |
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 |
47 |
Number Of Medical Services |
230 |
Number Of Medicare Beneficiaries With Medical Services |
111 |
Total Medical Submitted Charge Amount |
548394.19 |
Total Medical Medicare Allowed Amount |
158535.11 |
Total Medical Medicare Payment Amount |
123832.55 |
Total Medical Medicare Standardized Payment Amount |
126503.55 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
38 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
71 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
82 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
10 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0657 |