National Provider Identifier [NPI]: |
1770781254 |
Last Name Of The Provider |
BAHRAMI |
First Name Of The Provider |
SOON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3810 SPRINGHURST BLVD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402416100 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
3265 |
Number Of Medicare Beneficiaries |
1240 |
Total Submitted Charge Amount |
319007 |
Total Medicare Allowed Amount |
135010.66 |
Total Medicare Payment Amount |
103768.23 |
Total Medicare Standardized Payment Amount |
86781.13 |
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 |
9 |
Number Of Medical Services |
3265 |
Number Of Medicare Beneficiaries With Medical Services |
1240 |
Total Medical Submitted Charge Amount |
319007 |
Total Medical Medicare Allowed Amount |
135010.66 |
Total Medical Medicare Payment Amount |
103768.23 |
Total Medical Medicare Standardized Payment Amount |
86781.13 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
552 |
Number Of Beneficiaries Age 75 to 84 |
418 |
Number Of Beneficiaries Age Greater 84 |
188 |
Number Of Female Beneficiaries |
594 |
Number Of Male Beneficiaries |
646 |
Number Of Non Hispanic White Beneficiaries |
1199 |
Number Of Black or African American Beneficiaries |
17 |
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 |
1159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1233 |