National Provider Identifier [NPI]: |
1275527756 |
Last Name Of The Provider |
MOURADIAN |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3625 UNIVERSITY BLVD S |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322164207 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
282 |
Number Of Medicare Beneficiaries |
226 |
Total Submitted Charge Amount |
403200 |
Total Medicare Allowed Amount |
58459.48 |
Total Medicare Payment Amount |
45693.86 |
Total Medicare Standardized Payment Amount |
44340.82 |
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 |
59 |
Number Of Medical Services |
282 |
Number Of Medicare Beneficiaries With Medical Services |
226 |
Total Medical Submitted Charge Amount |
403200 |
Total Medical Medicare Allowed Amount |
58459.48 |
Total Medical Medicare Payment Amount |
45693.86 |
Total Medical Medicare Standardized Payment Amount |
44340.82 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
166 |
Number Of Black or African American Beneficiaries |
43 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
83 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.6189 |