National Provider Identifier [NPI]: |
1225035348 |
Last Name Of The Provider |
ISAAC |
First Name Of The Provider |
MOHSEN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1163 COUNTRY CLUB RD |
Street Address 2 Of The Provider |
MELENYZER PAVILION |
City Of The Provider |
MONONGAHELA |
Zip Code Of The Provider |
150631013 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1739 |
Number Of Medicare Beneficiaries |
124 |
Total Submitted Charge Amount |
452588 |
Total Medicare Allowed Amount |
138424.69 |
Total Medicare Payment Amount |
108292.95 |
Total Medicare Standardized Payment Amount |
104727.37 |
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 |
33 |
Number Of Medical Services |
1739 |
Number Of Medicare Beneficiaries With Medical Services |
124 |
Total Medical Submitted Charge Amount |
452588 |
Total Medical Medicare Allowed Amount |
138424.69 |
Total Medical Medicare Payment Amount |
108292.95 |
Total Medical Medicare Standardized Payment Amount |
104727.37 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
72 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
112 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
75 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9109 |