National Provider Identifier [NPI]: |
1033127873 |
Last Name Of The Provider |
JAFARIAN |
First Name Of The Provider |
ALI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1143 S. BUCKNER BLVD. |
Street Address 2 Of The Provider |
STE 133 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752174304 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1582 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
116671 |
Total Medicare Allowed Amount |
88214.63 |
Total Medicare Payment Amount |
62156.44 |
Total Medicare Standardized Payment Amount |
63906.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
91 |
Number Of Medicare Beneficiaries With Drug Services |
68 |
Total Drug Submitted ChargeAmount |
2209 |
Total Drug Medicare AllowedAmount |
936.65 |
Total Drug Medicare PaymentAmount |
898.22 |
Total Drug Medicare Standardized Payment Amount |
898.22 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
1491 |
Number Of Medicare Beneficiaries With Medical Services |
291 |
Total Medical Submitted Charge Amount |
114462 |
Total Medical Medicare Allowed Amount |
87277.98 |
Total Medical Medicare Payment Amount |
61258.22 |
Total Medical Medicare Standardized Payment Amount |
63008.74 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
126 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
108 |
Number Of Black or African American Beneficiaries |
75 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
162 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2944 |