National Provider Identifier [NPI]: |
1316919442 |
Last Name Of The Provider |
KELADA |
First Name Of The Provider |
YOUSSRY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
680 SUNRISE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROSEVILLE |
Zip Code Of The Provider |
95661 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
3147 |
Number Of Medicare Beneficiaries |
700 |
Total Submitted Charge Amount |
409839.83 |
Total Medicare Allowed Amount |
280409 |
Total Medicare Payment Amount |
201314.48 |
Total Medicare Standardized Payment Amount |
195135.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
103 |
Number Of Medicare Beneficiaries With Drug Services |
84 |
Total Drug Submitted ChargeAmount |
4750 |
Total Drug Medicare AllowedAmount |
2456.36 |
Total Drug Medicare PaymentAmount |
2371.2 |
Total Drug Medicare Standardized Payment Amount |
2371.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
3044 |
Number Of Medicare Beneficiaries With Medical Services |
700 |
Total Medical Submitted Charge Amount |
405089.83 |
Total Medical Medicare Allowed Amount |
277952.64 |
Total Medical Medicare Payment Amount |
198943.28 |
Total Medical Medicare Standardized Payment Amount |
192764.27 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
148 |
Number Of Beneficiaries Age 65 to 74 |
269 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
402 |
Number Of Male Beneficiaries |
298 |
Number Of Non Hispanic White Beneficiaries |
542 |
Number Of Black or African American Beneficiaries |
34 |
Number Of AsianPacific Islander Beneficiaries |
34 |
Number Of Hispanic Beneficiaries |
73 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
393 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
307 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6184 |