National Provider Identifier [NPI]: |
1831122647 |
Last Name Of The Provider |
NEGUSSIE |
First Name Of The Provider |
YEHEYIS |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1111 SPRING ST |
Street Address 2 Of The Provider |
SUITE 214 |
City Of The Provider |
SILVER SPRING |
Zip Code Of The Provider |
209104003 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
4252 |
Number Of Medicare Beneficiaries |
331 |
Total Submitted Charge Amount |
477563 |
Total Medicare Allowed Amount |
276621.72 |
Total Medicare Payment Amount |
211071.37 |
Total Medicare Standardized Payment Amount |
190909.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
103 |
Number Of Medicare Beneficiaries With Drug Services |
74 |
Total Drug Submitted ChargeAmount |
3467 |
Total Drug Medicare AllowedAmount |
1109.61 |
Total Drug Medicare PaymentAmount |
1078.62 |
Total Drug Medicare Standardized Payment Amount |
1078.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
4149 |
Number Of Medicare Beneficiaries With Medical Services |
331 |
Total Medical Submitted Charge Amount |
474096 |
Total Medical Medicare Allowed Amount |
275512.11 |
Total Medical Medicare Payment Amount |
209992.75 |
Total Medical Medicare Standardized Payment Amount |
189830.61 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
91 |
Number Of Black or African American Beneficiaries |
190 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
27 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
180 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
1.6918 |