National Provider Identifier [NPI]: |
1023001682 |
Last Name Of The Provider |
SAKS |
First Name Of The Provider |
SHANI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2632 N 20TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850061339 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
2668 |
Number Of Medicare Beneficiaries |
868 |
Total Submitted Charge Amount |
741036 |
Total Medicare Allowed Amount |
286151.12 |
Total Medicare Payment Amount |
214270.89 |
Total Medicare Standardized Payment Amount |
227687.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
404 |
Number Of Medicare Beneficiaries With Drug Services |
106 |
Total Drug Submitted ChargeAmount |
53645 |
Total Drug Medicare AllowedAmount |
21035.83 |
Total Drug Medicare PaymentAmount |
16109.39 |
Total Drug Medicare Standardized Payment Amount |
16109.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
2264 |
Number Of Medicare Beneficiaries With Medical Services |
867 |
Total Medical Submitted Charge Amount |
687391 |
Total Medical Medicare Allowed Amount |
265115.29 |
Total Medical Medicare Payment Amount |
198161.5 |
Total Medical Medicare Standardized Payment Amount |
211578.14 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
394 |
Number Of Beneficiaries Age 75 to 84 |
307 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
393 |
Number Of Male Beneficiaries |
475 |
Number Of Non Hispanic White Beneficiaries |
690 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
65 |
Number Of American Indian Alaska Native Beneficiaries |
72 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
776 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.37 |