National Provider Identifier [NPI]: |
1063421865 |
Last Name Of The Provider |
SHAMS |
First Name Of The Provider |
FARIBORZ |
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 |
515 S BEACH BLVD |
Street Address 2 Of The Provider |
STE F |
City Of The Provider |
ANAHEIM |
Zip Code Of The Provider |
928041812 |
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 |
48 |
Number Of Services |
9089 |
Number Of Medicare Beneficiaries |
793 |
Total Submitted Charge Amount |
1548177.46 |
Total Medicare Allowed Amount |
880286.6 |
Total Medicare Payment Amount |
687811.4 |
Total Medicare Standardized Payment Amount |
636363.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
124 |
Number Of Medicare Beneficiaries With Drug Services |
99 |
Total Drug Submitted ChargeAmount |
3698 |
Total Drug Medicare AllowedAmount |
1943.48 |
Total Drug Medicare PaymentAmount |
1892.86 |
Total Drug Medicare Standardized Payment Amount |
1892.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
8965 |
Number Of Medicare Beneficiaries With Medical Services |
793 |
Total Medical Submitted Charge Amount |
1544479.46 |
Total Medical Medicare Allowed Amount |
878343.12 |
Total Medical Medicare Payment Amount |
685918.54 |
Total Medical Medicare Standardized Payment Amount |
634470.98 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
254 |
Number Of Beneficiaries Age 65 to 74 |
205 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
152 |
Number Of Female Beneficiaries |
452 |
Number Of Male Beneficiaries |
341 |
Number Of Non Hispanic White Beneficiaries |
498 |
Number Of Black or African American Beneficiaries |
42 |
Number Of AsianPacific Islander Beneficiaries |
89 |
Number Of Hispanic Beneficiaries |
141 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
223 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
570 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
46 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
48 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.3069 |