National Provider Identifier [NPI]: |
1902876683 |
Last Name Of The Provider |
ELSAADI |
First Name Of The Provider |
MAGDI |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1700 NORTH WATERMAN AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN BERNARDINO |
Zip Code Of The Provider |
924045105 |
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 |
86 |
Number Of Services |
4745 |
Number Of Medicare Beneficiaries |
298 |
Total Submitted Charge Amount |
201811 |
Total Medicare Allowed Amount |
147166.5 |
Total Medicare Payment Amount |
113553.52 |
Total Medicare Standardized Payment Amount |
110831.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
191 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
2238 |
Total Drug Medicare AllowedAmount |
872.68 |
Total Drug Medicare PaymentAmount |
822.04 |
Total Drug Medicare Standardized Payment Amount |
822.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
4554 |
Number Of Medicare Beneficiaries With Medical Services |
298 |
Total Medical Submitted Charge Amount |
199573 |
Total Medical Medicare Allowed Amount |
146293.82 |
Total Medical Medicare Payment Amount |
112731.48 |
Total Medical Medicare Standardized Payment Amount |
110009.14 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
101 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
150 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
170 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
71 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
171 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.759 |