National Provider Identifier [NPI]: |
1720353212 |
Last Name Of The Provider |
ALAM |
First Name Of The Provider |
IREEM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8260 MIRA MESA BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921262662 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
281 |
Number Of Medicare Beneficiaries |
146 |
Total Submitted Charge Amount |
10349.88 |
Total Medicare Allowed Amount |
9816.31 |
Total Medicare Payment Amount |
7997.43 |
Total Medicare Standardized Payment Amount |
8946.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
112 |
Number Of Medicare Beneficiaries With Drug Services |
105 |
Total Drug Submitted ChargeAmount |
3598.88 |
Total Drug Medicare AllowedAmount |
3598.88 |
Total Drug Medicare PaymentAmount |
3526.88 |
Total Drug Medicare Standardized Payment Amount |
3526.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
169 |
Number Of Medicare Beneficiaries With Medical Services |
146 |
Total Medical Submitted Charge Amount |
6751 |
Total Medical Medicare Allowed Amount |
6217.43 |
Total Medical Medicare Payment Amount |
4470.55 |
Total Medical Medicare Standardized Payment Amount |
5419.45 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
82 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
106 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
23 |
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 |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9455 |