National Provider Identifier [NPI]: |
1912194937 |
Last Name Of The Provider |
MONSEF |
First Name Of The Provider |
HENGAMEH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
50 BELLEFONTAINE ST |
Street Address 2 Of The Provider |
SUIT # 307 |
City Of The Provider |
PASADENA |
Zip Code Of The Provider |
911053132 |
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 |
14 |
Number Of Services |
962 |
Number Of Medicare Beneficiaries |
361 |
Total Submitted Charge Amount |
178661 |
Total Medicare Allowed Amount |
102837.9 |
Total Medicare Payment Amount |
77642.22 |
Total Medicare Standardized Payment Amount |
73001.38 |
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 |
14 |
Number Of Medical Services |
962 |
Number Of Medicare Beneficiaries With Medical Services |
361 |
Total Medical Submitted Charge Amount |
178661 |
Total Medical Medicare Allowed Amount |
102837.9 |
Total Medical Medicare Payment Amount |
77642.22 |
Total Medical Medicare Standardized Payment Amount |
73001.38 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
115 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
175 |
Number Of Non Hispanic White Beneficiaries |
215 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
45 |
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
189 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
172 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.2477 |