National Provider Identifier [NPI]: |
1992740963 |
Last Name Of The Provider |
KARBASIAN-ESFAHANI |
First Name Of The Provider |
MERAT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3535 N BELL SCHOOL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKFORD |
Zip Code Of The Provider |
611146624 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
15752 |
Number Of Medicare Beneficiaries |
419 |
Total Submitted Charge Amount |
860432.47 |
Total Medicare Allowed Amount |
243654.18 |
Total Medicare Payment Amount |
185806.63 |
Total Medicare Standardized Payment Amount |
188453.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
28 |
Number Of Drug Services |
13639 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
469087.16 |
Total Drug Medicare AllowedAmount |
81833.77 |
Total Drug Medicare PaymentAmount |
64157.63 |
Total Drug Medicare Standardized Payment Amount |
64157.63 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
2113 |
Number Of Medicare Beneficiaries With Medical Services |
419 |
Total Medical Submitted Charge Amount |
391345.31 |
Total Medical Medicare Allowed Amount |
161820.41 |
Total Medical Medicare Payment Amount |
121649 |
Total Medical Medicare Standardized Payment Amount |
124296.1 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
241 |
Number Of Male Beneficiaries |
178 |
Number Of Non Hispanic White Beneficiaries |
348 |
Number Of Black or African American Beneficiaries |
49 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
307 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
35 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
2.1035 |