National Provider Identifier [NPI]: |
1912954637 |
Last Name Of The Provider |
ALZOOBI |
First Name Of The Provider |
ANAS |
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 |
13011 S RIDGEWOOD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PALOS PARK |
Zip Code Of The Provider |
60464 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
852 |
Number Of Medicare Beneficiaries |
155 |
Total Submitted Charge Amount |
337677.61 |
Total Medicare Allowed Amount |
51697.13 |
Total Medicare Payment Amount |
39258.07 |
Total Medicare Standardized Payment Amount |
36226.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
196 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
8440 |
Total Drug Medicare AllowedAmount |
572.3 |
Total Drug Medicare PaymentAmount |
446.6 |
Total Drug Medicare Standardized Payment Amount |
446.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
656 |
Number Of Medicare Beneficiaries With Medical Services |
155 |
Total Medical Submitted Charge Amount |
329237.61 |
Total Medical Medicare Allowed Amount |
51124.83 |
Total Medical Medicare Payment Amount |
38811.47 |
Total Medical Medicare Standardized Payment Amount |
35779.66 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
107 |
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 |
98 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4438 |