National Provider Identifier [NPI]: |
1184630857 |
Last Name Of The Provider |
FARAH |
First Name Of The Provider |
WALID |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 CONGRESS ST |
Street Address 2 Of The Provider |
3RD FLOOR |
City Of The Provider |
QUINCY |
Zip Code Of The Provider |
021690908 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
87 |
Number Of Services |
5235 |
Number Of Medicare Beneficiaries |
273 |
Total Submitted Charge Amount |
408432 |
Total Medicare Allowed Amount |
146050.44 |
Total Medicare Payment Amount |
115926.18 |
Total Medicare Standardized Payment Amount |
111330.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
133 |
Number Of Medicare Beneficiaries With Drug Services |
116 |
Total Drug Submitted ChargeAmount |
5455 |
Total Drug Medicare AllowedAmount |
2395.77 |
Total Drug Medicare PaymentAmount |
2340.4 |
Total Drug Medicare Standardized Payment Amount |
2340.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
83 |
Number Of Medical Services |
5102 |
Number Of Medicare Beneficiaries With Medical Services |
273 |
Total Medical Submitted Charge Amount |
402977 |
Total Medical Medicare Allowed Amount |
143654.67 |
Total Medical Medicare Payment Amount |
113585.78 |
Total Medical Medicare Standardized Payment Amount |
108990.27 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
260 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
231 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.2708 |