National Provider Identifier [NPI]: |
1902080989 |
Last Name Of The Provider |
DANIELIAN |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10120 S EASTERN AVE |
Street Address 2 Of The Provider |
SUITE 120 |
City Of The Provider |
HENDERSON |
Zip Code Of The Provider |
890523951 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1472 |
Number Of Medicare Beneficiaries |
357 |
Total Submitted Charge Amount |
775142 |
Total Medicare Allowed Amount |
246512.02 |
Total Medicare Payment Amount |
192445.63 |
Total Medicare Standardized Payment Amount |
189706.32 |
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 |
20 |
Number Of Medical Services |
1472 |
Number Of Medicare Beneficiaries With Medical Services |
357 |
Total Medical Submitted Charge Amount |
775142 |
Total Medical Medicare Allowed Amount |
246512.02 |
Total Medical Medicare Payment Amount |
192445.63 |
Total Medical Medicare Standardized Payment Amount |
189706.32 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
205 |
Number Of Non Hispanic White Beneficiaries |
259 |
Number Of Black or African American Beneficiaries |
38 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
245 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
71 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
60 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
3.2767 |