National Provider Identifier [NPI]: |
1245275718 |
Last Name Of The Provider |
JENEVIZIAN |
First Name Of The Provider |
ARA |
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 |
6850 N DURANGO DR |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891494595 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
418 |
Number Of Medicare Beneficiaries |
122 |
Total Submitted Charge Amount |
55467 |
Total Medicare Allowed Amount |
44767.98 |
Total Medicare Payment Amount |
31207.55 |
Total Medicare Standardized Payment Amount |
31760.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
812 |
Total Drug Medicare AllowedAmount |
669.23 |
Total Drug Medicare PaymentAmount |
654.14 |
Total Drug Medicare Standardized Payment Amount |
654.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
395 |
Number Of Medicare Beneficiaries With Medical Services |
122 |
Total Medical Submitted Charge Amount |
54655 |
Total Medical Medicare Allowed Amount |
44098.75 |
Total Medical Medicare Payment Amount |
30553.41 |
Total Medical Medicare Standardized Payment Amount |
31105.94 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
72 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
86 |
Number Of Black or African American Beneficiaries |
12 |
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 |
101 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0062 |