National Provider Identifier [NPI]: |
1124271689 |
Last Name Of The Provider |
PAHLAVAN |
First Name Of The Provider |
SHANE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6550 FANNIN ST |
Street Address 2 Of The Provider |
SUITE 1727 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770302717 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
1124 |
Number Of Medicare Beneficiaries |
207 |
Total Submitted Charge Amount |
325205 |
Total Medicare Allowed Amount |
108882.71 |
Total Medicare Payment Amount |
78236.67 |
Total Medicare Standardized Payment Amount |
81268.6 |
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 |
77 |
Number Of Medical Services |
1124 |
Number Of Medicare Beneficiaries With Medical Services |
207 |
Total Medical Submitted Charge Amount |
325205 |
Total Medical Medicare Allowed Amount |
108882.71 |
Total Medical Medicare Payment Amount |
78236.67 |
Total Medical Medicare Standardized Payment Amount |
81268.6 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
172 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
12 |
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 |
178 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.2142 |