National Provider Identifier [NPI]: |
1083902092 |
Last Name Of The Provider |
HADI |
First Name Of The Provider |
MOLOOD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 N PEPPER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLTON |
Zip Code Of The Provider |
923241801 |
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 |
18 |
Number Of Services |
411 |
Number Of Medicare Beneficiaries |
245 |
Total Submitted Charge Amount |
81738 |
Total Medicare Allowed Amount |
32689.84 |
Total Medicare Payment Amount |
23216.81 |
Total Medicare Standardized Payment Amount |
21641.49 |
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 |
18 |
Number Of Medical Services |
411 |
Number Of Medicare Beneficiaries With Medical Services |
245 |
Total Medical Submitted Charge Amount |
81738 |
Total Medical Medicare Allowed Amount |
32689.84 |
Total Medical Medicare Payment Amount |
23216.81 |
Total Medical Medicare Standardized Payment Amount |
21641.49 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
161 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
193 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
26 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
191 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2443 |