National Provider Identifier [NPI]: |
1386732931 |
Last Name Of The Provider |
MOHAMADI |
First Name Of The Provider |
DAVID |
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 |
14624 SHERMAN WAY |
Street Address 2 Of The Provider |
# 406 |
City Of The Provider |
VAN NUYS |
Zip Code Of The Provider |
914052241 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1060 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
181318 |
Total Medicare Allowed Amount |
138559.89 |
Total Medicare Payment Amount |
99364.49 |
Total Medicare Standardized Payment Amount |
93554.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
28 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
935 |
Total Drug Medicare AllowedAmount |
235.13 |
Total Drug Medicare PaymentAmount |
229.19 |
Total Drug Medicare Standardized Payment Amount |
229.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
1032 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
180383 |
Total Medical Medicare Allowed Amount |
138324.76 |
Total Medical Medicare Payment Amount |
99135.3 |
Total Medical Medicare Standardized Payment Amount |
93325.56 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
64 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
109 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
39 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
172 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5574 |