National Provider Identifier [NPI]: |
1174597231 |
Last Name Of The Provider |
BRAHME |
First Name Of The Provider |
SEVIL |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8745 AERO DRIVE |
Street Address 2 Of The Provider |
STE 200 |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921231774 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
90 |
Number Of Services |
5447 |
Number Of Medicare Beneficiaries |
1190 |
Total Submitted Charge Amount |
315725.8 |
Total Medicare Allowed Amount |
97797.09 |
Total Medicare Payment Amount |
69115.36 |
Total Medicare Standardized Payment Amount |
66224.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
3956 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
4005.8 |
Total Drug Medicare AllowedAmount |
834.08 |
Total Drug Medicare PaymentAmount |
647.83 |
Total Drug Medicare Standardized Payment Amount |
647.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
88 |
Number Of Medical Services |
1491 |
Number Of Medicare Beneficiaries With Medical Services |
1190 |
Total Medical Submitted Charge Amount |
311720 |
Total Medical Medicare Allowed Amount |
96963.01 |
Total Medical Medicare Payment Amount |
68467.53 |
Total Medical Medicare Standardized Payment Amount |
65576.38 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
603 |
Number Of Beneficiaries Age 75 to 84 |
336 |
Number Of Beneficiaries Age Greater 84 |
174 |
Number Of Female Beneficiaries |
691 |
Number Of Male Beneficiaries |
499 |
Number Of Non Hispanic White Beneficiaries |
1006 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
70 |
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
1086 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1302 |