National Provider Identifier [NPI]: |
1124016852 |
Last Name Of The Provider |
NOURI |
First Name Of The Provider |
SOHEILA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3945 E PARADISE FALLS DRIVE |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857126687 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
1010 |
Number Of Medicare Beneficiaries |
319 |
Total Submitted Charge Amount |
216398 |
Total Medicare Allowed Amount |
108208.53 |
Total Medicare Payment Amount |
83970.63 |
Total Medicare Standardized Payment Amount |
84954.18 |
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 |
11 |
Number Of Medical Services |
1010 |
Number Of Medicare Beneficiaries With Medical Services |
319 |
Total Medical Submitted Charge Amount |
216398 |
Total Medical Medicare Allowed Amount |
108208.53 |
Total Medical Medicare Payment Amount |
83970.63 |
Total Medical Medicare Standardized Payment Amount |
84954.18 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
167 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
257 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8641 |