National Provider Identifier [NPI]: |
1457464331 |
Last Name Of The Provider |
NESSARY |
First Name Of The Provider |
ZABIULLAH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5925 SAN VICENTE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900196630 |
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 |
37 |
Number Of Services |
460 |
Number Of Medicare Beneficiaries |
271 |
Total Submitted Charge Amount |
193208 |
Total Medicare Allowed Amount |
37975.44 |
Total Medicare Payment Amount |
28488.98 |
Total Medicare Standardized Payment Amount |
33185.52 |
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 |
37 |
Number Of Medical Services |
460 |
Number Of Medicare Beneficiaries With Medical Services |
271 |
Total Medical Submitted Charge Amount |
193208 |
Total Medical Medicare Allowed Amount |
37975.44 |
Total Medical Medicare Payment Amount |
28488.98 |
Total Medical Medicare Standardized Payment Amount |
33185.52 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
117 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
139 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
81 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
78 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
193 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
28 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.3835 |