National Provider Identifier [NPI]: |
1689692956 |
Last Name Of The Provider |
HADDAD |
First Name Of The Provider |
FADI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8860 CENTER DR |
Street Address 2 Of The Provider |
SUITE 320 |
City Of The Provider |
LA MESA |
Zip Code Of The Provider |
919423068 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
1748 |
Number Of Medicare Beneficiaries |
384 |
Total Submitted Charge Amount |
366976 |
Total Medicare Allowed Amount |
182916.77 |
Total Medicare Payment Amount |
142278.01 |
Total Medicare Standardized Payment Amount |
138977.28 |
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 |
10 |
Number Of Medical Services |
1748 |
Number Of Medicare Beneficiaries With Medical Services |
384 |
Total Medical Submitted Charge Amount |
366976 |
Total Medical Medicare Allowed Amount |
182916.77 |
Total Medical Medicare Payment Amount |
142278.01 |
Total Medical Medicare Standardized Payment Amount |
138977.28 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
120 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
200 |
Number Of Male Beneficiaries |
184 |
Number Of Non Hispanic White Beneficiaries |
240 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
65 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
227 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
67 |
Percent Of With Chronic Kidney Disease |
69 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
3.6174 |