National Provider Identifier [NPI]: |
1912121377 |
Last Name Of The Provider |
SAMIMI |
First Name Of The Provider |
BABAK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
741 S ORANGE AVE |
Street Address 2 Of The Provider |
2ND FLOOR |
City Of The Provider |
WEST COVINA |
Zip Code Of The Provider |
917902662 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
823 |
Number Of Medicare Beneficiaries |
164 |
Total Submitted Charge Amount |
127414.88 |
Total Medicare Allowed Amount |
84166.32 |
Total Medicare Payment Amount |
63323.95 |
Total Medicare Standardized Payment Amount |
59130.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
200 |
Number Of Medicare Beneficiaries With Drug Services |
55 |
Total Drug Submitted ChargeAmount |
11119.88 |
Total Drug Medicare AllowedAmount |
6455.21 |
Total Drug Medicare PaymentAmount |
5061.12 |
Total Drug Medicare Standardized Payment Amount |
5061.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
623 |
Number Of Medicare Beneficiaries With Medical Services |
164 |
Total Medical Submitted Charge Amount |
116295 |
Total Medical Medicare Allowed Amount |
77711.11 |
Total Medical Medicare Payment Amount |
58262.83 |
Total Medical Medicare Standardized Payment Amount |
54069.85 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
115 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
73 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
61 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
80 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3186 |