National Provider Identifier [NPI]: |
1255344131 |
Last Name Of The Provider |
ABDELAAL |
First Name Of The Provider |
ALI |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
715 W SHERMAN AVE |
Street Address 2 Of The Provider |
SUITE J |
City Of The Provider |
HARRISON |
Zip Code Of The Provider |
726012743 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
35862 |
Number Of Medicare Beneficiaries |
392 |
Total Submitted Charge Amount |
1880993.99 |
Total Medicare Allowed Amount |
1030777.15 |
Total Medicare Payment Amount |
796586.73 |
Total Medicare Standardized Payment Amount |
802037.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
40 |
Number Of Drug Services |
30010 |
Number Of Medicare Beneficiaries With Drug Services |
97 |
Total Drug Submitted ChargeAmount |
1392729.53 |
Total Drug Medicare AllowedAmount |
702942.09 |
Total Drug Medicare PaymentAmount |
550897.33 |
Total Drug Medicare Standardized Payment Amount |
550897.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
5852 |
Number Of Medicare Beneficiaries With Medical Services |
392 |
Total Medical Submitted Charge Amount |
488264.46 |
Total Medical Medicare Allowed Amount |
327835.06 |
Total Medical Medicare Payment Amount |
245689.4 |
Total Medical Medicare Standardized Payment Amount |
251140.05 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
247 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
285 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
43 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.8367 |