National Provider Identifier [NPI]: |
1376799064 |
Last Name Of The Provider |
ALI |
First Name Of The Provider |
TABREEZ |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6970 W PATRICK LN |
Street Address 2 Of The Provider |
SUITE 140 |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891130269 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
8922 |
Number Of Medicare Beneficiaries |
736 |
Total Submitted Charge Amount |
2504318 |
Total Medicare Allowed Amount |
714013.15 |
Total Medicare Payment Amount |
558465.07 |
Total Medicare Standardized Payment Amount |
548157.76 |
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 |
15 |
Number Of Medical Services |
8922 |
Number Of Medicare Beneficiaries With Medical Services |
736 |
Total Medical Submitted Charge Amount |
2504318 |
Total Medical Medicare Allowed Amount |
714013.15 |
Total Medical Medicare Payment Amount |
558465.07 |
Total Medical Medicare Standardized Payment Amount |
548157.76 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
161 |
Number Of Beneficiaries Age 65 to 74 |
257 |
Number Of Beneficiaries Age 75 to 84 |
205 |
Number Of Beneficiaries Age Greater 84 |
113 |
Number Of Female Beneficiaries |
386 |
Number Of Male Beneficiaries |
350 |
Number Of Non Hispanic White Beneficiaries |
521 |
Number Of Black or African American Beneficiaries |
95 |
Number Of AsianPacific Islander Beneficiaries |
30 |
Number Of Hispanic Beneficiaries |
72 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
455 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
281 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
3.298 |