National Provider Identifier [NPI]: |
1134245913 |
Last Name Of The Provider |
GHAFFARI |
First Name Of The Provider |
SAMAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2121 FOUNTAIN DR |
Street Address 2 Of The Provider |
SUITE D |
City Of The Provider |
SNELLVILLE |
Zip Code Of The Provider |
300787023 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
13123 |
Number Of Medicare Beneficiaries |
494 |
Total Submitted Charge Amount |
1041297.4 |
Total Medicare Allowed Amount |
426297.45 |
Total Medicare Payment Amount |
332946.66 |
Total Medicare Standardized Payment Amount |
332576.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
9411 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
123725.02 |
Total Drug Medicare AllowedAmount |
60275.9 |
Total Drug Medicare PaymentAmount |
47256.34 |
Total Drug Medicare Standardized Payment Amount |
47256.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
3712 |
Number Of Medicare Beneficiaries With Medical Services |
494 |
Total Medical Submitted Charge Amount |
917572.38 |
Total Medical Medicare Allowed Amount |
366021.55 |
Total Medical Medicare Payment Amount |
285690.32 |
Total Medical Medicare Standardized Payment Amount |
285320.3 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
117 |
Number Of Female Beneficiaries |
285 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
290 |
Number Of Black or African American Beneficiaries |
185 |
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 |
311 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
183 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
47 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
2.7227 |