National Provider Identifier [NPI]: |
1306848577 |
Last Name Of The Provider |
KAWAMLEH |
First Name Of The Provider |
ABDUL |
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 |
6375 US HIGHWAY 6 STE B |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTAGE |
Zip Code Of The Provider |
463685218 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
6041 |
Number Of Medicare Beneficiaries |
2237 |
Total Submitted Charge Amount |
1423367.02 |
Total Medicare Allowed Amount |
494458.51 |
Total Medicare Payment Amount |
370430.06 |
Total Medicare Standardized Payment Amount |
392659.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
344 |
Number Of Medicare Beneficiaries With Drug Services |
85 |
Total Drug Submitted ChargeAmount |
55040 |
Total Drug Medicare AllowedAmount |
18227.51 |
Total Drug Medicare PaymentAmount |
13864.61 |
Total Drug Medicare Standardized Payment Amount |
13864.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
108 |
Number Of Medical Services |
5697 |
Number Of Medicare Beneficiaries With Medical Services |
2237 |
Total Medical Submitted Charge Amount |
1368327.02 |
Total Medical Medicare Allowed Amount |
476231 |
Total Medical Medicare Payment Amount |
356565.45 |
Total Medical Medicare Standardized Payment Amount |
378794.77 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
492 |
Number Of Beneficiaries Age 65 to 74 |
731 |
Number Of Beneficiaries Age 75 to 84 |
646 |
Number Of Beneficiaries Age Greater 84 |
368 |
Number Of Female Beneficiaries |
1219 |
Number Of Male Beneficiaries |
1018 |
Number Of Non Hispanic White Beneficiaries |
1296 |
Number Of Black or African American Beneficiaries |
798 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
121 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1567 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
670 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.1911 |