National Provider Identifier [NPI]: |
1982677068 |
Last Name Of The Provider |
KANI |
First Name Of The Provider |
ABDUL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8245 BAYBERRY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322567432 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
3127.5 |
Number Of Medicare Beneficiaries |
545 |
Total Submitted Charge Amount |
744532.08 |
Total Medicare Allowed Amount |
443189.64 |
Total Medicare Payment Amount |
342122.78 |
Total Medicare Standardized Payment Amount |
346240.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
496.5 |
Number Of Medicare Beneficiaries With Drug Services |
63 |
Total Drug Submitted ChargeAmount |
22521.62 |
Total Drug Medicare AllowedAmount |
10399.62 |
Total Drug Medicare PaymentAmount |
8145.95 |
Total Drug Medicare Standardized Payment Amount |
8145.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
2631 |
Number Of Medicare Beneficiaries With Medical Services |
545 |
Total Medical Submitted Charge Amount |
722010.46 |
Total Medical Medicare Allowed Amount |
432790.02 |
Total Medical Medicare Payment Amount |
333976.83 |
Total Medical Medicare Standardized Payment Amount |
338094.21 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
128 |
Number Of Beneficiaries Age 65 to 74 |
200 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
307 |
Number Of Male Beneficiaries |
238 |
Number Of Non Hispanic White Beneficiaries |
346 |
Number Of Black or African American Beneficiaries |
127 |
Number Of AsianPacific Islander Beneficiaries |
27 |
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
350 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
195 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
71 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.3229 |