National Provider Identifier [NPI]: |
1962453225 |
Last Name Of The Provider |
KATHAWALA |
First Name Of The Provider |
AHSAN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1264 WESLEY DR |
Street Address 2 Of The Provider |
SUITE 501 |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381166400 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
130 |
Number Of Services |
11322 |
Number Of Medicare Beneficiaries |
351 |
Total Submitted Charge Amount |
1253552 |
Total Medicare Allowed Amount |
377927.27 |
Total Medicare Payment Amount |
284505.45 |
Total Medicare Standardized Payment Amount |
313918.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
2407 |
Number Of Medicare Beneficiaries With Drug Services |
237 |
Total Drug Submitted ChargeAmount |
63232 |
Total Drug Medicare AllowedAmount |
8995.63 |
Total Drug Medicare PaymentAmount |
7922.45 |
Total Drug Medicare Standardized Payment Amount |
7922.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
117 |
Number Of Medical Services |
8915 |
Number Of Medicare Beneficiaries With Medical Services |
351 |
Total Medical Submitted Charge Amount |
1190320 |
Total Medical Medicare Allowed Amount |
368931.64 |
Total Medical Medicare Payment Amount |
276583 |
Total Medical Medicare Standardized Payment Amount |
305995.73 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
90 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
223 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
284 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
205 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
146 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.4108 |