National Provider Identifier [NPI]: |
1548295066 |
Last Name Of The Provider |
SOLIMAN |
First Name Of The Provider |
JANET |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11946 HAWTHORNE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HAWTHORNE |
Zip Code Of The Provider |
902503016 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
642 |
Number Of Medicare Beneficiaries |
114 |
Total Submitted Charge Amount |
60127 |
Total Medicare Allowed Amount |
47142.04 |
Total Medicare Payment Amount |
32471.96 |
Total Medicare Standardized Payment Amount |
31299.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
960 |
Total Drug Medicare AllowedAmount |
673.8 |
Total Drug Medicare PaymentAmount |
660.36 |
Total Drug Medicare Standardized Payment Amount |
660.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
618 |
Number Of Medicare Beneficiaries With Medical Services |
114 |
Total Medical Submitted Charge Amount |
59167 |
Total Medical Medicare Allowed Amount |
46468.24 |
Total Medical Medicare Payment Amount |
31811.6 |
Total Medical Medicare Standardized Payment Amount |
30639.31 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
75 |
Number Of Male Beneficiaries |
39 |
Number Of Non Hispanic White Beneficiaries |
23 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
73 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
24 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3514 |