National Provider Identifier [NPI]: |
1730316928 |
Last Name Of The Provider |
BAHADOR |
First Name Of The Provider |
FARSHAD |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4094 4TH AVE |
Street Address 2 Of The Provider |
SUITE 200, MAIL CODE: 0834 |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921032143 |
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 |
72 |
Number Of Services |
553 |
Number Of Medicare Beneficiaries |
388 |
Total Submitted Charge Amount |
75852 |
Total Medicare Allowed Amount |
17333.13 |
Total Medicare Payment Amount |
13424.92 |
Total Medicare Standardized Payment Amount |
13302.13 |
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 |
72 |
Number Of Medical Services |
553 |
Number Of Medicare Beneficiaries With Medical Services |
388 |
Total Medical Submitted Charge Amount |
75852 |
Total Medical Medicare Allowed Amount |
17333.13 |
Total Medical Medicare Payment Amount |
13424.92 |
Total Medical Medicare Standardized Payment Amount |
13302.13 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
192 |
Number Of Non Hispanic White Beneficiaries |
271 |
Number Of Black or African American Beneficiaries |
31 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
246 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
142 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0741 |