National Provider Identifier [NPI]: |
1700048840 |
Last Name Of The Provider |
SALEH |
First Name Of The Provider |
NERMINE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13610 BRUCE B DOWNS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336134650 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
422 |
Number Of Medicare Beneficiaries |
202 |
Total Submitted Charge Amount |
59230 |
Total Medicare Allowed Amount |
25226.7 |
Total Medicare Payment Amount |
15710.63 |
Total Medicare Standardized Payment Amount |
16196.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
480 |
Total Drug Medicare AllowedAmount |
180.17 |
Total Drug Medicare PaymentAmount |
147.19 |
Total Drug Medicare Standardized Payment Amount |
147.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
403 |
Number Of Medicare Beneficiaries With Medical Services |
202 |
Total Medical Submitted Charge Amount |
58750 |
Total Medical Medicare Allowed Amount |
25046.53 |
Total Medical Medicare Payment Amount |
15563.44 |
Total Medical Medicare Standardized Payment Amount |
16049.09 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
139 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
153 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0355 |