National Provider Identifier [NPI]: |
1124300082 |
Last Name Of The Provider |
SOLOMON |
First Name Of The Provider |
BORNA |
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 |
15031 RINALDI ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MISSION HILLS |
Zip Code Of The Provider |
913451207 |
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 |
9 |
Number Of Services |
1624 |
Number Of Medicare Beneficiaries |
462 |
Total Submitted Charge Amount |
403665 |
Total Medicare Allowed Amount |
188196.32 |
Total Medicare Payment Amount |
147510.31 |
Total Medicare Standardized Payment Amount |
138728.71 |
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 |
9 |
Number Of Medical Services |
1624 |
Number Of Medicare Beneficiaries With Medical Services |
462 |
Total Medical Submitted Charge Amount |
403665 |
Total Medical Medicare Allowed Amount |
188196.32 |
Total Medical Medicare Payment Amount |
147510.31 |
Total Medical Medicare Standardized Payment Amount |
138728.71 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
105 |
Number Of Female Beneficiaries |
252 |
Number Of Male Beneficiaries |
210 |
Number Of Non Hispanic White Beneficiaries |
264 |
Number Of Black or African American Beneficiaries |
36 |
Number Of AsianPacific Islander Beneficiaries |
31 |
Number Of Hispanic Beneficiaries |
117 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
339 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.9296 |