National Provider Identifier [NPI]: |
1114911732 |
Last Name Of The Provider |
ZEBAIDA |
First Name Of The Provider |
OREN |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7777 FOREST LN |
Street Address 2 Of The Provider |
SUITE C-300 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752302505 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
98 |
Number Of Services |
2673 |
Number Of Medicare Beneficiaries |
270 |
Total Submitted Charge Amount |
264560 |
Total Medicare Allowed Amount |
111152.78 |
Total Medicare Payment Amount |
82440.66 |
Total Medicare Standardized Payment Amount |
82838.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
561 |
Number Of Medicare Beneficiaries With Drug Services |
97 |
Total Drug Submitted ChargeAmount |
28235 |
Total Drug Medicare AllowedAmount |
9768.75 |
Total Drug Medicare PaymentAmount |
8331 |
Total Drug Medicare Standardized Payment Amount |
8331 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
84 |
Number Of Medical Services |
2112 |
Number Of Medicare Beneficiaries With Medical Services |
270 |
Total Medical Submitted Charge Amount |
236325 |
Total Medical Medicare Allowed Amount |
101384.03 |
Total Medical Medicare Payment Amount |
74109.66 |
Total Medical Medicare Standardized Payment Amount |
74507.98 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
246 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1368 |