National Provider Identifier [NPI]: |
1265469522 |
Last Name Of The Provider |
BAGHERI |
First Name Of The Provider |
ALI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3600 GASTON AVE |
Street Address 2 Of The Provider |
#550 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752461904 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1046 |
Number Of Medicare Beneficiaries |
405 |
Total Submitted Charge Amount |
345111 |
Total Medicare Allowed Amount |
74817.02 |
Total Medicare Payment Amount |
58514.06 |
Total Medicare Standardized Payment Amount |
58329.3 |
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 |
14 |
Number Of Medical Services |
1046 |
Number Of Medicare Beneficiaries With Medical Services |
405 |
Total Medical Submitted Charge Amount |
345111 |
Total Medical Medicare Allowed Amount |
74817.02 |
Total Medical Medicare Payment Amount |
58514.06 |
Total Medical Medicare Standardized Payment Amount |
58329.3 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
181 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
203 |
Number Of Black or African American Beneficiaries |
145 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
233 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
172 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.6929 |