National Provider Identifier [NPI]: |
1023095957 |
Last Name Of The Provider |
HOUGEIR |
First Name Of The Provider |
FIRAS |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
629 BEAVER RUIN RD NW STE B |
Street Address 2 Of The Provider |
|
City Of The Provider |
LILBURN |
Zip Code Of The Provider |
300473437 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
6600 |
Number Of Medicare Beneficiaries |
1055 |
Total Submitted Charge Amount |
2118450 |
Total Medicare Allowed Amount |
1098806.64 |
Total Medicare Payment Amount |
839304.86 |
Total Medicare Standardized Payment Amount |
857300.46 |
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 |
68 |
Number Of Medical Services |
6600 |
Number Of Medicare Beneficiaries With Medical Services |
1055 |
Total Medical Submitted Charge Amount |
2118450 |
Total Medical Medicare Allowed Amount |
1098806.64 |
Total Medical Medicare Payment Amount |
839304.86 |
Total Medical Medicare Standardized Payment Amount |
857300.46 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
473 |
Number Of Beneficiaries Age 75 to 84 |
367 |
Number Of Beneficiaries Age Greater 84 |
157 |
Number Of Female Beneficiaries |
466 |
Number Of Male Beneficiaries |
589 |
Number Of Non Hispanic White Beneficiaries |
964 |
Number Of Black or African American Beneficiaries |
74 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
948 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1985 |