National Provider Identifier [NPI]: |
1801060405 |
Last Name Of The Provider |
SHAFAGHI |
First Name Of The Provider |
NEDA |
Middle Initial Of The Provider |
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Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8631 W. 3RD ST |
Street Address 2 Of The Provider |
STE 1140E |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900485965 |
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 |
15 |
Number Of Services |
51 |
Number Of Medicare Beneficiaries |
23 |
Total Submitted Charge Amount |
6510 |
Total Medicare Allowed Amount |
3344.84 |
Total Medicare Payment Amount |
2130.32 |
Total Medicare Standardized Payment Amount |
2178.1 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
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Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
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Total Medical Submitted Charge Amount |
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Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
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Number Of Beneficiaries Age 65 to 74 |
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Number Of Beneficiaries Age 75 to 84 |
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Number Of Beneficiaries Age Greater 84 |
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Number Of Female Beneficiaries |
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Number Of Male Beneficiaries |
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Number Of Non Hispanic White Beneficiaries |
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Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
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Number Of Beneficiaries With Medicare Only Entitlement |
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Number Of Beneficiaries With Medicare Medicaid Entitlement |
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Percent Of With Atrial Fibrillation |
0 |
Percent Of With Alzheimers Disease or Dementia |
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Percent Of With Asthma |
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Percent Of With Cancer |
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Percent Of With Heart Failure |
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Percent Of With Chronic Kidney Disease |
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Percent Of With Chronic Obstructive Pulmonary Disease |
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Percent Of With Depression |
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Percent Of With Diabetes |
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Percent Of With Hyperlipidemia |
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Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
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Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
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Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.7848 |