National Provider Identifier [NPI]: |
1821059841 |
Last Name Of The Provider |
ABREHA |
First Name Of The Provider |
AMANUEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9816 W MONTGOMERY ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
77088 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
639 |
Number Of Medicare Beneficiaries |
279 |
Total Submitted Charge Amount |
272407 |
Total Medicare Allowed Amount |
68715.1 |
Total Medicare Payment Amount |
53004.77 |
Total Medicare Standardized Payment Amount |
54709.76 |
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 |
37 |
Number Of Medical Services |
639 |
Number Of Medicare Beneficiaries With Medical Services |
279 |
Total Medical Submitted Charge Amount |
272407 |
Total Medical Medicare Allowed Amount |
68715.1 |
Total Medical Medicare Payment Amount |
53004.77 |
Total Medical Medicare Standardized Payment Amount |
54709.76 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
170 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
214 |
Number Of Black or African American Beneficiaries |
|
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 |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.0042 |