National Provider Identifier [NPI]: |
1811983232 |
Last Name Of The Provider |
IBRAHEEM |
First Name Of The Provider |
LAJA |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4000 LONG BEACH BLVD |
Street Address 2 Of The Provider |
SUITE 228 |
City Of The Provider |
LONG BEACH |
Zip Code Of The Provider |
908072617 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
294 |
Number Of Medicare Beneficiaries |
95 |
Total Submitted Charge Amount |
50250 |
Total Medicare Allowed Amount |
27471.83 |
Total Medicare Payment Amount |
20718.77 |
Total Medicare Standardized Payment Amount |
19806.49 |
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 |
8 |
Number Of Medical Services |
294 |
Number Of Medicare Beneficiaries With Medical Services |
95 |
Total Medical Submitted Charge Amount |
50250 |
Total Medical Medicare Allowed Amount |
27471.83 |
Total Medical Medicare Payment Amount |
20718.77 |
Total Medical Medicare Standardized Payment Amount |
19806.49 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
34 |
Number Of Non Hispanic White Beneficiaries |
59 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
37 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
44 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
61 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.9055 |