National Provider Identifier [NPI]: |
1811910284 |
Last Name Of The Provider |
DROUBI |
First Name Of The Provider |
BASEM |
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 |
20997 LORAIN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FAIRVIEW PARK |
Zip Code Of The Provider |
441262030 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
128 |
Number Of Services |
1721 |
Number Of Medicare Beneficiaries |
752 |
Total Submitted Charge Amount |
1557813 |
Total Medicare Allowed Amount |
213884.88 |
Total Medicare Payment Amount |
165972.4 |
Total Medicare Standardized Payment Amount |
165234.97 |
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 |
128 |
Number Of Medical Services |
1721 |
Number Of Medicare Beneficiaries With Medical Services |
752 |
Total Medical Submitted Charge Amount |
1557813 |
Total Medical Medicare Allowed Amount |
213884.88 |
Total Medical Medicare Payment Amount |
165972.4 |
Total Medical Medicare Standardized Payment Amount |
165234.97 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
165 |
Number Of Beneficiaries Age 65 to 74 |
281 |
Number Of Beneficiaries Age 75 to 84 |
215 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
400 |
Number Of Male Beneficiaries |
352 |
Number Of Non Hispanic White Beneficiaries |
577 |
Number Of Black or African American Beneficiaries |
76 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
79 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
471 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
281 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.6003 |