National Provider Identifier [NPI]: |
1972703114 |
Last Name Of The Provider |
PAPPOE |
First Name Of The Provider |
AKHENATON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1900 ROYALTY DR |
Street Address 2 Of The Provider |
SUITE 130 |
City Of The Provider |
POMONA |
Zip Code Of The Provider |
917673032 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
1294 |
Number Of Medicare Beneficiaries |
160 |
Total Submitted Charge Amount |
430977 |
Total Medicare Allowed Amount |
225783.42 |
Total Medicare Payment Amount |
161544.46 |
Total Medicare Standardized Payment Amount |
165776.44 |
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 |
16 |
Number Of Medical Services |
1294 |
Number Of Medicare Beneficiaries With Medical Services |
160 |
Total Medical Submitted Charge Amount |
430977 |
Total Medical Medicare Allowed Amount |
225783.42 |
Total Medical Medicare Payment Amount |
161544.46 |
Total Medical Medicare Standardized Payment Amount |
165776.44 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
76 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
39 |
Number Of Black or African American Beneficiaries |
25 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
78 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
58 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
5.8026 |