National Provider Identifier [NPI]: |
1215153077 |
Last Name Of The Provider |
PATEL |
First Name Of The Provider |
AIYUB |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 MAIN ST |
Street Address 2 Of The Provider |
SUITE 630 |
City Of The Provider |
PEORIA |
Zip Code Of The Provider |
616021005 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
2070 |
Number Of Medicare Beneficiaries |
829 |
Total Submitted Charge Amount |
544746.2 |
Total Medicare Allowed Amount |
219348.57 |
Total Medicare Payment Amount |
164154.49 |
Total Medicare Standardized Payment Amount |
167794.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
2070 |
Number Of Medicare Beneficiaries With Medical Services |
829 |
Total Medical Submitted Charge Amount |
544746.2 |
Total Medical Medicare Allowed Amount |
219348.57 |
Total Medical Medicare Payment Amount |
164154.49 |
Total Medical Medicare Standardized Payment Amount |
167794.38 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
143 |
Number Of Beneficiaries Age 65 to 74 |
336 |
Number Of Beneficiaries Age 75 to 84 |
227 |
Number Of Beneficiaries Age Greater 84 |
123 |
Number Of Female Beneficiaries |
419 |
Number Of Male Beneficiaries |
410 |
Number Of Non Hispanic White Beneficiaries |
754 |
Number Of Black or African American Beneficiaries |
60 |
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 |
626 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
203 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
50 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.8388 |