National Provider Identifier [NPI]: |
1619105863 |
Last Name Of The Provider |
GOHARI |
First Name Of The Provider |
JANAN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4475 REGENCY PLACE |
Street Address 2 Of The Provider |
SUITE 303 |
City Of The Provider |
WHITE PLAINS |
Zip Code Of The Provider |
206953077 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1444 |
Number Of Medicare Beneficiaries |
354 |
Total Submitted Charge Amount |
180970 |
Total Medicare Allowed Amount |
139421.47 |
Total Medicare Payment Amount |
109293.18 |
Total Medicare Standardized Payment Amount |
107501.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
745 |
Total Drug Medicare AllowedAmount |
340.97 |
Total Drug Medicare PaymentAmount |
328.92 |
Total Drug Medicare Standardized Payment Amount |
328.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1429 |
Number Of Medicare Beneficiaries With Medical Services |
354 |
Total Medical Submitted Charge Amount |
180225 |
Total Medical Medicare Allowed Amount |
139080.5 |
Total Medical Medicare Payment Amount |
108964.26 |
Total Medical Medicare Standardized Payment Amount |
107172.72 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
141 |
Number Of Non Hispanic White Beneficiaries |
230 |
Number Of Black or African American Beneficiaries |
112 |
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 |
273 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
26 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
53 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.079 |