National Provider Identifier [NPI]: |
1740235019 |
Last Name Of The Provider |
MORAGHEBI |
First Name Of The Provider |
PARDISE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
26800 CROWN VALLEY PKWY |
Street Address 2 Of The Provider |
SUITE 315 |
City Of The Provider |
MISSION VIEJO |
Zip Code Of The Provider |
926916384 |
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 |
16 |
Number Of Services |
1118 |
Number Of Medicare Beneficiaries |
372 |
Total Submitted Charge Amount |
174190.38 |
Total Medicare Allowed Amount |
119613.23 |
Total Medicare Payment Amount |
93278.63 |
Total Medicare Standardized Payment Amount |
86935.48 |
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 |
16 |
Number Of Medical Services |
1118 |
Number Of Medicare Beneficiaries With Medical Services |
372 |
Total Medical Submitted Charge Amount |
174190.38 |
Total Medical Medicare Allowed Amount |
119613.23 |
Total Medical Medicare Payment Amount |
93278.63 |
Total Medical Medicare Standardized Payment Amount |
86935.48 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
202 |
Number Of Male Beneficiaries |
170 |
Number Of Non Hispanic White Beneficiaries |
325 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
19 |
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 |
317 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.1016 |