National Provider Identifier [NPI]: |
1245201680 |
Last Name Of The Provider |
RAGHEB |
First Name Of The Provider |
DINA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7117 BROCKTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
RIVERSIDE |
Zip Code Of The Provider |
925062615 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
81 |
Number Of Services |
538 |
Number Of Medicare Beneficiaries |
423 |
Total Submitted Charge Amount |
133874.8 |
Total Medicare Allowed Amount |
82194.85 |
Total Medicare Payment Amount |
59935.79 |
Total Medicare Standardized Payment Amount |
56997.04 |
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 |
81 |
Number Of Medical Services |
538 |
Number Of Medicare Beneficiaries With Medical Services |
423 |
Total Medical Submitted Charge Amount |
133874.8 |
Total Medical Medicare Allowed Amount |
82194.85 |
Total Medical Medicare Payment Amount |
59935.79 |
Total Medical Medicare Standardized Payment Amount |
56997.04 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
191 |
Number Of Beneficiaries Age 75 to 84 |
117 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
272 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
283 |
Number Of Black or African American Beneficiaries |
44 |
Number Of AsianPacific Islander Beneficiaries |
26 |
Number Of Hispanic Beneficiaries |
55 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
336 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
87 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1227 |