National Provider Identifier [NPI]: |
1518034115 |
Last Name Of The Provider |
JAHANPANAH |
First Name Of The Provider |
FERESHTEH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1333 E MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
EL CAJON |
Zip Code Of The Provider |
920216540 |
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 |
12 |
Number Of Services |
9503 |
Number Of Medicare Beneficiaries |
254 |
Total Submitted Charge Amount |
509725 |
Total Medicare Allowed Amount |
244460.67 |
Total Medicare Payment Amount |
174389.77 |
Total Medicare Standardized Payment Amount |
183917.56 |
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 |
12 |
Number Of Medical Services |
9503 |
Number Of Medicare Beneficiaries With Medical Services |
254 |
Total Medical Submitted Charge Amount |
509725 |
Total Medical Medicare Allowed Amount |
244460.67 |
Total Medical Medicare Payment Amount |
174389.77 |
Total Medical Medicare Standardized Payment Amount |
183917.56 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
136 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
172 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
24 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
41 |
Number Of Beneficiaries With Medicare Only Entitlement |
11 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
243 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
31 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3331 |