National Provider Identifier [NPI]: |
1174782213 |
Last Name Of The Provider |
SHOURBAJI |
First Name Of The Provider |
NADER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12631 E 17TH AVE |
Street Address 2 Of The Provider |
MAIL STOP B202, SUITE 4600 |
City Of The Provider |
AURORA |
Zip Code Of The Provider |
800452527 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hand Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
17 |
Number Of Medicare Beneficiaries |
15 |
Total Submitted Charge Amount |
12757.43 |
Total Medicare Allowed Amount |
2564.92 |
Total Medicare Payment Amount |
2010.93 |
Total Medicare Standardized Payment Amount |
2019.89 |
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 |
9 |
Number Of Medical Services |
17 |
Number Of Medicare Beneficiaries With Medical Services |
15 |
Total Medical Submitted Charge Amount |
12757.43 |
Total Medical Medicare Allowed Amount |
2564.92 |
Total Medical Medicare Payment Amount |
2010.93 |
Total Medical Medicare Standardized Payment Amount |
2019.89 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
0 |
Percent Of With Asthma |
0 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
0 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
0 |
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
|
Percent Of With Hypertension |
|
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1899 |