National Provider Identifier [NPI]: |
1265571202 |
Last Name Of The Provider |
HANNA |
First Name Of The Provider |
REMA |
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 |
1661 SOQUEL AVE. |
Street Address 2 Of The Provider |
STE D |
City Of The Provider |
SANTA CRUZ |
Zip Code Of The Provider |
950651709 |
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 |
17 |
Number Of Services |
781 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
242225 |
Total Medicare Allowed Amount |
85814.76 |
Total Medicare Payment Amount |
66956.2 |
Total Medicare Standardized Payment Amount |
65256.51 |
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 |
17 |
Number Of Medical Services |
781 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
242225 |
Total Medical Medicare Allowed Amount |
85814.76 |
Total Medical Medicare Payment Amount |
66956.2 |
Total Medical Medicare Standardized Payment Amount |
65256.51 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
218 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
197 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
25 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.8074 |