National Provider Identifier [NPI]: |
1306990809 |
Last Name Of The Provider |
HANNA |
First Name Of The Provider |
BERNADINE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D., |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6140 S FORT APACHE RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891486736 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
87 |
Number Of Services |
2170 |
Number Of Medicare Beneficiaries |
530 |
Total Submitted Charge Amount |
886649 |
Total Medicare Allowed Amount |
306942.76 |
Total Medicare Payment Amount |
236714.01 |
Total Medicare Standardized Payment Amount |
231251.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
45 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
495 |
Total Drug Medicare AllowedAmount |
34.39 |
Total Drug Medicare PaymentAmount |
27.12 |
Total Drug Medicare Standardized Payment Amount |
27.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
84 |
Number Of Medical Services |
2125 |
Number Of Medicare Beneficiaries With Medical Services |
530 |
Total Medical Submitted Charge Amount |
886154 |
Total Medical Medicare Allowed Amount |
306908.37 |
Total Medical Medicare Payment Amount |
236686.89 |
Total Medical Medicare Standardized Payment Amount |
231224.05 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
177 |
Number Of Beneficiaries Age 65 to 74 |
186 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
298 |
Number Of Male Beneficiaries |
232 |
Number Of Non Hispanic White Beneficiaries |
323 |
Number Of Black or African American Beneficiaries |
99 |
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
77 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
330 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
200 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.6289 |