National Provider Identifier [NPI]: |
1871844720 |
Last Name Of The Provider |
ABDESHAHIAN |
First Name Of The Provider |
EHSAN |
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 |
67 WALL ST APT 10F |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW YORK |
Zip Code Of The Provider |
100053188 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
7388 |
Number Of Medicare Beneficiaries |
466 |
Total Submitted Charge Amount |
545231.01 |
Total Medicare Allowed Amount |
254477.09 |
Total Medicare Payment Amount |
211570.23 |
Total Medicare Standardized Payment Amount |
188490.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
808 |
Number Of Medicare Beneficiaries With Drug Services |
121 |
Total Drug Submitted ChargeAmount |
3244 |
Total Drug Medicare AllowedAmount |
878.61 |
Total Drug Medicare PaymentAmount |
684.96 |
Total Drug Medicare Standardized Payment Amount |
684.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
57 |
Number Of Medical Services |
6580 |
Number Of Medicare Beneficiaries With Medical Services |
466 |
Total Medical Submitted Charge Amount |
541987.01 |
Total Medical Medicare Allowed Amount |
253598.48 |
Total Medical Medicare Payment Amount |
210885.27 |
Total Medical Medicare Standardized Payment Amount |
187805.81 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
161 |
Number Of Beneficiaries Age 65 to 74 |
177 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
274 |
Number Of Male Beneficiaries |
192 |
Number Of Non Hispanic White Beneficiaries |
353 |
Number Of Black or African American Beneficiaries |
101 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
364 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2771 |