National Provider Identifier [NPI]: |
1730179615 |
Last Name Of The Provider |
HANNA |
First Name Of The Provider |
HAIFA |
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 |
6701 ROCKSIDE RD |
Street Address 2 Of The Provider |
STE 365 |
City Of The Provider |
INDEPENDENCE |
Zip Code Of The Provider |
441312316 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
1651 |
Number Of Medicare Beneficiaries |
289 |
Total Submitted Charge Amount |
708487.12 |
Total Medicare Allowed Amount |
267232.02 |
Total Medicare Payment Amount |
205947.14 |
Total Medicare Standardized Payment Amount |
210617.64 |
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 |
23 |
Number Of Medical Services |
1651 |
Number Of Medicare Beneficiaries With Medical Services |
289 |
Total Medical Submitted Charge Amount |
708487.12 |
Total Medical Medicare Allowed Amount |
267232.02 |
Total Medical Medicare Payment Amount |
205947.14 |
Total Medical Medicare Standardized Payment Amount |
210617.64 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
187 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
134 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
155 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
67 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
6.1762 |