National Provider Identifier [NPI]: |
1376709147 |
Last Name Of The Provider |
SHOEB |
First Name Of The Provider |
MARWA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
533 PARNASSUS AVE |
Street Address 2 Of The Provider |
SUITE U127A, BOX 0131 |
City Of The Provider |
SAN FRANCISCO |
Zip Code Of The Provider |
941430131 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
274 |
Number Of Medicare Beneficiaries |
97 |
Total Submitted Charge Amount |
113948 |
Total Medicare Allowed Amount |
28867.86 |
Total Medicare Payment Amount |
22640.02 |
Total Medicare Standardized Payment Amount |
19955.55 |
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 |
13 |
Number Of Medical Services |
274 |
Number Of Medicare Beneficiaries With Medical Services |
97 |
Total Medical Submitted Charge Amount |
113948 |
Total Medical Medicare Allowed Amount |
28867.86 |
Total Medical Medicare Payment Amount |
22640.02 |
Total Medical Medicare Standardized Payment Amount |
19955.55 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
56 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
43 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
20 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
34 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.5971 |