National Provider Identifier [NPI]: |
1386656635 |
Last Name Of The Provider |
ISRAEL |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
435 N, ROXBURY DR. #303 |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEVERLY HILLS |
Zip Code Of The Provider |
90210 |
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 |
91 |
Number Of Services |
7847 |
Number Of Medicare Beneficiaries |
574 |
Total Submitted Charge Amount |
406274.11 |
Total Medicare Allowed Amount |
233676.83 |
Total Medicare Payment Amount |
192823.06 |
Total Medicare Standardized Payment Amount |
188833.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
291 |
Number Of Medicare Beneficiaries With Drug Services |
132 |
Total Drug Submitted ChargeAmount |
3231.06 |
Total Drug Medicare AllowedAmount |
3080 |
Total Drug Medicare PaymentAmount |
2903.52 |
Total Drug Medicare Standardized Payment Amount |
2903.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
7556 |
Number Of Medicare Beneficiaries With Medical Services |
574 |
Total Medical Submitted Charge Amount |
403043.05 |
Total Medical Medicare Allowed Amount |
230596.83 |
Total Medical Medicare Payment Amount |
189919.54 |
Total Medical Medicare Standardized Payment Amount |
185929.89 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
200 |
Number Of Beneficiaries Age 75 to 84 |
202 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
443 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
537 |
Number Of Black or African American Beneficiaries |
13 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
11 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0415 |