National Provider Identifier [NPI]: |
1043324742 |
Last Name Of The Provider |
RIZKALLA |
First Name Of The Provider |
SUZANNE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
25815 BARTON ROAD STE C102 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOMA LINDA |
Zip Code Of The Provider |
923543857 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
11323 |
Number Of Medicare Beneficiaries |
899 |
Total Submitted Charge Amount |
1195725 |
Total Medicare Allowed Amount |
572864.09 |
Total Medicare Payment Amount |
430958.12 |
Total Medicare Standardized Payment Amount |
418660.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
1982 |
Number Of Medicare Beneficiaries With Drug Services |
387 |
Total Drug Submitted ChargeAmount |
41505 |
Total Drug Medicare AllowedAmount |
10919.85 |
Total Drug Medicare PaymentAmount |
9968.41 |
Total Drug Medicare Standardized Payment Amount |
9968.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
9341 |
Number Of Medicare Beneficiaries With Medical Services |
899 |
Total Medical Submitted Charge Amount |
1154220 |
Total Medical Medicare Allowed Amount |
561944.24 |
Total Medical Medicare Payment Amount |
420989.71 |
Total Medical Medicare Standardized Payment Amount |
408691.73 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
123 |
Number Of Beneficiaries Age 65 to 74 |
346 |
Number Of Beneficiaries Age 75 to 84 |
296 |
Number Of Beneficiaries Age Greater 84 |
134 |
Number Of Female Beneficiaries |
614 |
Number Of Male Beneficiaries |
285 |
Number Of Non Hispanic White Beneficiaries |
643 |
Number Of Black or African American Beneficiaries |
80 |
Number Of AsianPacific Islander Beneficiaries |
42 |
Number Of Hispanic Beneficiaries |
94 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
633 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
266 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
29 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3173 |