National Provider Identifier [NPI]: |
1720063464 |
Last Name Of The Provider |
SHBEEB |
First Name Of The Provider |
IMAD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10931 CHERRY ST |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
LOS ALAMITOS |
Zip Code Of The Provider |
907202445 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Colorectal Surgery (formerly proctology) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
1631 |
Number Of Medicare Beneficiaries |
431 |
Total Submitted Charge Amount |
501518 |
Total Medicare Allowed Amount |
314729.58 |
Total Medicare Payment Amount |
240483.21 |
Total Medicare Standardized Payment Amount |
217340.45 |
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 |
57 |
Number Of Medical Services |
1631 |
Number Of Medicare Beneficiaries With Medical Services |
431 |
Total Medical Submitted Charge Amount |
501518 |
Total Medical Medicare Allowed Amount |
314729.58 |
Total Medical Medicare Payment Amount |
240483.21 |
Total Medical Medicare Standardized Payment Amount |
217340.45 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
196 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
226 |
Number Of Male Beneficiaries |
205 |
Number Of Non Hispanic White Beneficiaries |
318 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
38 |
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
357 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
30 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3899 |