National Provider Identifier [NPI]: |
1598794646 |
Last Name Of The Provider |
WOLDEABEZGI |
First Name Of The Provider |
ASHEBIR |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11637 TERRACE DR |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
WALDORF |
Zip Code Of The Provider |
206023706 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
3697 |
Number Of Medicare Beneficiaries |
679 |
Total Submitted Charge Amount |
620300 |
Total Medicare Allowed Amount |
419051.6 |
Total Medicare Payment Amount |
325016.65 |
Total Medicare Standardized Payment Amount |
307529.97 |
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 |
3697 |
Number Of Medicare Beneficiaries With Medical Services |
679 |
Total Medical Submitted Charge Amount |
620300 |
Total Medical Medicare Allowed Amount |
419051.6 |
Total Medical Medicare Payment Amount |
325016.65 |
Total Medical Medicare Standardized Payment Amount |
307529.97 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
207 |
Number Of Beneficiaries Age 65 to 74 |
226 |
Number Of Beneficiaries Age 75 to 84 |
169 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
363 |
Number Of Male Beneficiaries |
316 |
Number Of Non Hispanic White Beneficiaries |
270 |
Number Of Black or African American Beneficiaries |
379 |
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 |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
355 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
324 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
3.2418 |