National Provider Identifier [NPI]: |
1205861770 |
Last Name Of The Provider |
ZAMAN |
First Name Of The Provider |
MANILA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1800 WESTERN AVE |
Street Address 2 Of The Provider |
SUITE 302 |
City Of The Provider |
SAN BERNARDINO |
Zip Code Of The Provider |
924111356 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
1210 |
Number Of Medicare Beneficiaries |
376 |
Total Submitted Charge Amount |
352760 |
Total Medicare Allowed Amount |
117260.01 |
Total Medicare Payment Amount |
89574.93 |
Total Medicare Standardized Payment Amount |
88220.17 |
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 |
41 |
Number Of Medical Services |
1210 |
Number Of Medicare Beneficiaries With Medical Services |
376 |
Total Medical Submitted Charge Amount |
352760 |
Total Medical Medicare Allowed Amount |
117260.01 |
Total Medical Medicare Payment Amount |
89574.93 |
Total Medical Medicare Standardized Payment Amount |
88220.17 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
205 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
285 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
286 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8147 |