National Provider Identifier [NPI]: |
1194783944 |
Last Name Of The Provider |
KHAN |
First Name Of The Provider |
BABAR |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1115 N RONALD REAGAN PKWY |
Street Address 2 Of The Provider |
STE 206 |
City Of The Provider |
AVON |
Zip Code Of The Provider |
461236911 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
545 |
Number Of Medicare Beneficiaries |
194 |
Total Submitted Charge Amount |
153575 |
Total Medicare Allowed Amount |
59941.27 |
Total Medicare Payment Amount |
46862.95 |
Total Medicare Standardized Payment Amount |
48486.79 |
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 |
26 |
Number Of Medical Services |
545 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
153575 |
Total Medical Medicare Allowed Amount |
59941.27 |
Total Medical Medicare Payment Amount |
46862.95 |
Total Medical Medicare Standardized Payment Amount |
48486.79 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
113 |
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 |
62 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
132 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
57 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.6698 |