National Provider Identifier [NPI]: |
1841409190 |
Last Name Of The Provider |
BERRADA |
First Name Of The Provider |
DRISS |
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 |
4000 COLISEUM DR |
Street Address 2 Of The Provider |
STE 350 |
City Of The Provider |
HAMPTON |
Zip Code Of The Provider |
236665906 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1480 |
Number Of Medicare Beneficiaries |
528 |
Total Submitted Charge Amount |
385764 |
Total Medicare Allowed Amount |
131149.03 |
Total Medicare Payment Amount |
102279.43 |
Total Medicare Standardized Payment Amount |
104401.79 |
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 |
27 |
Number Of Medical Services |
1480 |
Number Of Medicare Beneficiaries With Medical Services |
528 |
Total Medical Submitted Charge Amount |
385764 |
Total Medical Medicare Allowed Amount |
131149.03 |
Total Medical Medicare Payment Amount |
102279.43 |
Total Medical Medicare Standardized Payment Amount |
104401.79 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
156 |
Number Of Beneficiaries Age Greater 84 |
123 |
Number Of Female Beneficiaries |
296 |
Number Of Male Beneficiaries |
232 |
Number Of Non Hispanic White Beneficiaries |
396 |
Number Of Black or African American Beneficiaries |
108 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
355 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
173 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.3191 |