National Provider Identifier [NPI]: |
1831170869 |
Last Name Of The Provider |
KHADEMI |
First Name Of The Provider |
JAMSHID |
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 |
1800 MULBERRY ST. |
Street Address 2 Of The Provider |
|
City Of The Provider |
SCRANTON |
Zip Code Of The Provider |
185106800 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
100 |
Number Of Services |
898 |
Number Of Medicare Beneficiaries |
568 |
Total Submitted Charge Amount |
836066.68 |
Total Medicare Allowed Amount |
106141.09 |
Total Medicare Payment Amount |
82667.44 |
Total Medicare Standardized Payment Amount |
83308.67 |
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 |
100 |
Number Of Medical Services |
898 |
Number Of Medicare Beneficiaries With Medical Services |
568 |
Total Medical Submitted Charge Amount |
836066.68 |
Total Medical Medicare Allowed Amount |
106141.09 |
Total Medical Medicare Payment Amount |
82667.44 |
Total Medical Medicare Standardized Payment Amount |
83308.67 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
228 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
287 |
Number Of Male Beneficiaries |
281 |
Number Of Non Hispanic White Beneficiaries |
544 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
426 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
142 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7682 |