National Provider Identifier [NPI]: |
1033387030 |
Last Name Of The Provider |
MESRI |
First Name Of The Provider |
ELHAM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
145 S MAPLE DR APT 204 |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEVERLY HILLS |
Zip Code Of The Provider |
902123362 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1463 |
Number Of Medicare Beneficiaries |
361 |
Total Submitted Charge Amount |
117405 |
Total Medicare Allowed Amount |
51837.34 |
Total Medicare Payment Amount |
37438.08 |
Total Medicare Standardized Payment Amount |
40465.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
139 |
Number Of Medicare Beneficiaries With Drug Services |
75 |
Total Drug Submitted ChargeAmount |
3845 |
Total Drug Medicare AllowedAmount |
289.14 |
Total Drug Medicare PaymentAmount |
250.59 |
Total Drug Medicare Standardized Payment Amount |
250.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
1324 |
Number Of Medicare Beneficiaries With Medical Services |
361 |
Total Medical Submitted Charge Amount |
113560 |
Total Medical Medicare Allowed Amount |
51548.2 |
Total Medical Medicare Payment Amount |
37187.49 |
Total Medical Medicare Standardized Payment Amount |
40215.23 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
222 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
23 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
310 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
18 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
343 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.9222 |