National Provider Identifier [NPI]: |
1275705949 |
Last Name Of The Provider |
TOMAJIAN |
First Name Of The Provider |
SAMIR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1340 BROAD AVE |
Street Address 2 Of The Provider |
SUITE 450 |
City Of The Provider |
GULFPORT |
Zip Code Of The Provider |
395012404 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
94 |
Number Of Services |
1530 |
Number Of Medicare Beneficiaries |
472 |
Total Submitted Charge Amount |
867265.5 |
Total Medicare Allowed Amount |
127228.61 |
Total Medicare Payment Amount |
96285.86 |
Total Medicare Standardized Payment Amount |
99577.58 |
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 |
94 |
Number Of Medical Services |
1530 |
Number Of Medicare Beneficiaries With Medical Services |
472 |
Total Medical Submitted Charge Amount |
867265.5 |
Total Medical Medicare Allowed Amount |
127228.61 |
Total Medical Medicare Payment Amount |
96285.86 |
Total Medical Medicare Standardized Payment Amount |
99577.58 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
158 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
290 |
Number Of Male Beneficiaries |
182 |
Number Of Non Hispanic White Beneficiaries |
366 |
Number Of Black or African American Beneficiaries |
89 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
303 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
169 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.506 |