National Provider Identifier [NPI]: |
1093719924 |
Last Name Of The Provider |
FARZAN |
First Name Of The Provider |
DAVID |
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 |
25 MARSTON ST |
Street Address 2 Of The Provider |
3RD FL |
City Of The Provider |
LAWRENCE |
Zip Code Of The Provider |
018412310 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1217 |
Number Of Medicare Beneficiaries |
504 |
Total Submitted Charge Amount |
339384.09 |
Total Medicare Allowed Amount |
121903.12 |
Total Medicare Payment Amount |
84723.78 |
Total Medicare Standardized Payment Amount |
87310.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
56 |
Number Of Medicare Beneficiaries With Drug Services |
49 |
Total Drug Submitted ChargeAmount |
1300.08 |
Total Drug Medicare AllowedAmount |
791.88 |
Total Drug Medicare PaymentAmount |
731.54 |
Total Drug Medicare Standardized Payment Amount |
731.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
1161 |
Number Of Medicare Beneficiaries With Medical Services |
504 |
Total Medical Submitted Charge Amount |
338084.01 |
Total Medical Medicare Allowed Amount |
121111.24 |
Total Medical Medicare Payment Amount |
83992.24 |
Total Medical Medicare Standardized Payment Amount |
86578.93 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
194 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
250 |
Number Of Male Beneficiaries |
254 |
Number Of Non Hispanic White Beneficiaries |
408 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
70 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
296 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
208 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9463 |