National Provider Identifier [NPI]: |
1043261373 |
Last Name Of The Provider |
MANI |
First Name Of The Provider |
MAJID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
865 3RD AVE |
Street Address 2 Of The Provider |
SUITE 112 |
City Of The Provider |
CHULA VISTA |
Zip Code Of The Provider |
919111300 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
14438 |
Number Of Medicare Beneficiaries |
1938 |
Total Submitted Charge Amount |
3777195 |
Total Medicare Allowed Amount |
1518507.47 |
Total Medicare Payment Amount |
1140296.7 |
Total Medicare Standardized Payment Amount |
1089687.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
815 |
Number Of Medicare Beneficiaries With Drug Services |
240 |
Total Drug Submitted ChargeAmount |
87045 |
Total Drug Medicare AllowedAmount |
31606.11 |
Total Drug Medicare PaymentAmount |
24672.19 |
Total Drug Medicare Standardized Payment Amount |
24672.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
13623 |
Number Of Medicare Beneficiaries With Medical Services |
1938 |
Total Medical Submitted Charge Amount |
3690150 |
Total Medical Medicare Allowed Amount |
1486901.36 |
Total Medical Medicare Payment Amount |
1115624.51 |
Total Medical Medicare Standardized Payment Amount |
1065015.05 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
302 |
Number Of Beneficiaries Age 65 to 74 |
792 |
Number Of Beneficiaries Age 75 to 84 |
614 |
Number Of Beneficiaries Age Greater 84 |
230 |
Number Of Female Beneficiaries |
1128 |
Number Of Male Beneficiaries |
810 |
Number Of Non Hispanic White Beneficiaries |
238 |
Number Of Black or African American Beneficiaries |
30 |
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
1635 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
476 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1462 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
69 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.8103 |