National Provider Identifier [NPI]: |
1669498416 |
Last Name Of The Provider |
ANNABI |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4930 OSBORNE DR STE A |
Street Address 2 Of The Provider |
|
City Of The Provider |
EL PASO |
Zip Code Of The Provider |
799221043 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
2523 |
Number Of Medicare Beneficiaries |
348 |
Total Submitted Charge Amount |
323797 |
Total Medicare Allowed Amount |
156808.1 |
Total Medicare Payment Amount |
119665.47 |
Total Medicare Standardized Payment Amount |
122025.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
1030 |
Total Drug Medicare AllowedAmount |
93.85 |
Total Drug Medicare PaymentAmount |
73.59 |
Total Drug Medicare Standardized Payment Amount |
73.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
2487 |
Number Of Medicare Beneficiaries With Medical Services |
348 |
Total Medical Submitted Charge Amount |
322767 |
Total Medical Medicare Allowed Amount |
156714.25 |
Total Medical Medicare Payment Amount |
119591.88 |
Total Medical Medicare Standardized Payment Amount |
121951.51 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
220 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
140 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
189 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
245 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3981 |