National Provider Identifier [NPI]: |
1770724999 |
Last Name Of The Provider |
SADAF |
First Name Of The Provider |
ALIYAH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1700 W VAN BUREN ST |
Street Address 2 Of The Provider |
SUITE 500 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606125500 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
913 |
Number Of Medicare Beneficiaries |
339 |
Total Submitted Charge Amount |
235698 |
Total Medicare Allowed Amount |
102550.95 |
Total Medicare Payment Amount |
79410.72 |
Total Medicare Standardized Payment Amount |
74783.06 |
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 |
17 |
Number Of Medical Services |
913 |
Number Of Medicare Beneficiaries With Medical Services |
339 |
Total Medical Submitted Charge Amount |
235698 |
Total Medical Medicare Allowed Amount |
102550.95 |
Total Medical Medicare Payment Amount |
79410.72 |
Total Medical Medicare Standardized Payment Amount |
74783.06 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
204 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
108 |
Number Of Black or African American Beneficiaries |
169 |
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 |
152 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
187 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
3.1438 |