National Provider Identifier [NPI]: |
1619177532 |
Last Name Of The Provider |
SHARIAT |
First Name Of The Provider |
CYRUS |
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 |
175 N. JACKSON AVE. |
Street Address 2 Of The Provider |
SUITE 105 |
City Of The Provider |
SAN JOSE |
Zip Code Of The Provider |
951161909 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
413 |
Number Of Medicare Beneficiaries |
186 |
Total Submitted Charge Amount |
201492 |
Total Medicare Allowed Amount |
87475.8 |
Total Medicare Payment Amount |
67525.56 |
Total Medicare Standardized Payment Amount |
62440.79 |
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 |
12 |
Number Of Medical Services |
413 |
Number Of Medicare Beneficiaries With Medical Services |
186 |
Total Medical Submitted Charge Amount |
201492 |
Total Medical Medicare Allowed Amount |
87475.8 |
Total Medical Medicare Payment Amount |
67525.56 |
Total Medical Medicare Standardized Payment Amount |
62440.79 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
73 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
67 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
90 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
96 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
68 |
Percent Of With Chronic Kidney Disease |
71 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
3.0316 |