National Provider Identifier [NPI]: |
1447448873 |
Last Name Of The Provider |
PEDARSANI |
First Name Of The Provider |
MARJAN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
23512 MADERO |
Street Address 2 Of The Provider |
|
City Of The Provider |
MISSION VIEJO |
Zip Code Of The Provider |
926912743 |
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 |
30 |
Number Of Services |
143 |
Number Of Medicare Beneficiaries |
49 |
Total Submitted Charge Amount |
19075 |
Total Medicare Allowed Amount |
9525.53 |
Total Medicare Payment Amount |
6365.46 |
Total Medicare Standardized Payment Amount |
5715.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
574 |
Total Drug Medicare AllowedAmount |
307.77 |
Total Drug Medicare PaymentAmount |
295.47 |
Total Drug Medicare Standardized Payment Amount |
295.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
112 |
Number Of Medicare Beneficiaries With Medical Services |
49 |
Total Medical Submitted Charge Amount |
18501 |
Total Medical Medicare Allowed Amount |
9217.76 |
Total Medical Medicare Payment Amount |
6069.99 |
Total Medical Medicare Standardized Payment Amount |
5420.5 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
33 |
Number Of Male Beneficiaries |
16 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
36 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
29 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0581 |