National Provider Identifier [NPI]: |
1629042429 |
Last Name Of The Provider |
HANNA |
First Name Of The Provider |
SOHEIL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 JOHNSON FERRY RD NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303421606 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
147 |
Number Of Services |
3354 |
Number Of Medicare Beneficiaries |
2396 |
Total Submitted Charge Amount |
622535 |
Total Medicare Allowed Amount |
140887.91 |
Total Medicare Payment Amount |
108633.88 |
Total Medicare Standardized Payment Amount |
109928.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
172 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
1065 |
Total Drug Medicare AllowedAmount |
104.38 |
Total Drug Medicare PaymentAmount |
71.49 |
Total Drug Medicare Standardized Payment Amount |
71.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
142 |
Number Of Medical Services |
3182 |
Number Of Medicare Beneficiaries With Medical Services |
2396 |
Total Medical Submitted Charge Amount |
621470 |
Total Medical Medicare Allowed Amount |
140783.53 |
Total Medical Medicare Payment Amount |
108562.39 |
Total Medical Medicare Standardized Payment Amount |
109856.9 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
317 |
Number Of Beneficiaries Age 65 to 74 |
1082 |
Number Of Beneficiaries Age 75 to 84 |
700 |
Number Of Beneficiaries Age Greater 84 |
297 |
Number Of Female Beneficiaries |
1482 |
Number Of Male Beneficiaries |
914 |
Number Of Non Hispanic White Beneficiaries |
1997 |
Number Of Black or African American Beneficiaries |
234 |
Number Of AsianPacific Islander Beneficiaries |
57 |
Number Of Hispanic Beneficiaries |
61 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2033 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
363 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4432 |