National Provider Identifier [NPI]: |
1649459850 |
Last Name Of The Provider |
RAFIEI |
First Name Of The Provider |
NASTARAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 MEDICAL PLZ |
Street Address 2 Of The Provider |
STE B-200 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900950001 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
159 |
Number Of Medicare Beneficiaries |
90 |
Total Submitted Charge Amount |
52146 |
Total Medicare Allowed Amount |
24786.65 |
Total Medicare Payment Amount |
19432.81 |
Total Medicare Standardized Payment Amount |
17742.75 |
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 |
10 |
Number Of Medical Services |
159 |
Number Of Medicare Beneficiaries With Medical Services |
90 |
Total Medical Submitted Charge Amount |
52146 |
Total Medical Medicare Allowed Amount |
24786.65 |
Total Medical Medicare Payment Amount |
19432.81 |
Total Medical Medicare Standardized Payment Amount |
17742.75 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
60 |
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 |
33 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
56 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
60 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
32 |
Percent Of With Stroke |
32 |
Average HCC Risk Score Of Beneficiaries |
3.0448 |