National Provider Identifier [NPI]: |
1871526301 |
Last Name Of The Provider |
BAHRAMI |
First Name Of The Provider |
POUYA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1245 WILSHIRE BLVD |
Street Address 2 Of The Provider |
SUITE 611 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900174810 |
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 |
25 |
Number Of Services |
1719 |
Number Of Medicare Beneficiaries |
399 |
Total Submitted Charge Amount |
148150.07 |
Total Medicare Allowed Amount |
143462.59 |
Total Medicare Payment Amount |
99158.84 |
Total Medicare Standardized Payment Amount |
94948.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
50 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
912 |
Total Drug Medicare AllowedAmount |
280.97 |
Total Drug Medicare PaymentAmount |
260.35 |
Total Drug Medicare Standardized Payment Amount |
260.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
1669 |
Number Of Medicare Beneficiaries With Medical Services |
399 |
Total Medical Submitted Charge Amount |
147238.07 |
Total Medical Medicare Allowed Amount |
143181.62 |
Total Medical Medicare Payment Amount |
98898.49 |
Total Medical Medicare Standardized Payment Amount |
94688.16 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
261 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
96 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
262 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
52 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
347 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.8912 |