National Provider Identifier [NPI]: |
1255357075 |
Last Name Of The Provider |
NAHHAS |
First Name Of The Provider |
FAYEZ |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1102 W TRENTON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDINBURG |
Zip Code Of The Provider |
785399105 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1666 |
Number Of Medicare Beneficiaries |
865 |
Total Submitted Charge Amount |
1047947 |
Total Medicare Allowed Amount |
168452.05 |
Total Medicare Payment Amount |
129548.53 |
Total Medicare Standardized Payment Amount |
133146.5 |
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 |
22 |
Number Of Medical Services |
1666 |
Number Of Medicare Beneficiaries With Medical Services |
865 |
Total Medical Submitted Charge Amount |
1047947 |
Total Medical Medicare Allowed Amount |
168452.05 |
Total Medical Medicare Payment Amount |
129548.53 |
Total Medical Medicare Standardized Payment Amount |
133146.5 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
173 |
Number Of Beneficiaries Age 65 to 74 |
248 |
Number Of Beneficiaries Age 75 to 84 |
283 |
Number Of Beneficiaries Age Greater 84 |
161 |
Number Of Female Beneficiaries |
474 |
Number Of Male Beneficiaries |
391 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
696 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
255 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
610 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
3.0778 |