National Provider Identifier [NPI]: |
1629056692 |
Last Name Of The Provider |
REZAEE |
First Name Of The Provider |
MEHRDAD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2030 FOREST AVE |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
SAN JOSE |
Zip Code Of The Provider |
951284833 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
81 |
Number Of Services |
3370 |
Number Of Medicare Beneficiaries |
701 |
Total Submitted Charge Amount |
751964.93 |
Total Medicare Allowed Amount |
460932.61 |
Total Medicare Payment Amount |
341874.94 |
Total Medicare Standardized Payment Amount |
308383.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
58 |
Number Of Medicare Beneficiaries With Drug Services |
58 |
Total Drug Submitted ChargeAmount |
14473.9 |
Total Drug Medicare AllowedAmount |
163.13 |
Total Drug Medicare PaymentAmount |
125.76 |
Total Drug Medicare Standardized Payment Amount |
125.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
3312 |
Number Of Medicare Beneficiaries With Medical Services |
701 |
Total Medical Submitted Charge Amount |
737491.03 |
Total Medical Medicare Allowed Amount |
460769.48 |
Total Medical Medicare Payment Amount |
341749.18 |
Total Medical Medicare Standardized Payment Amount |
308258.11 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
246 |
Number Of Beneficiaries Age Greater 84 |
193 |
Number Of Female Beneficiaries |
337 |
Number Of Male Beneficiaries |
364 |
Number Of Non Hispanic White Beneficiaries |
463 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
105 |
Number Of Hispanic Beneficiaries |
96 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
504 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
197 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4208 |