National Provider Identifier [NPI]: |
1942519533 |
Last Name Of The Provider |
KARA |
First Name Of The Provider |
FADI |
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 |
505 N MCCLURG CT |
Street Address 2 Of The Provider |
UNIT 4401 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606115420 |
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 |
19 |
Number Of Services |
1124 |
Number Of Medicare Beneficiaries |
678 |
Total Submitted Charge Amount |
348405.46 |
Total Medicare Allowed Amount |
129787.29 |
Total Medicare Payment Amount |
99891.98 |
Total Medicare Standardized Payment Amount |
102576.78 |
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 |
19 |
Number Of Medical Services |
1124 |
Number Of Medicare Beneficiaries With Medical Services |
678 |
Total Medical Submitted Charge Amount |
348405.46 |
Total Medical Medicare Allowed Amount |
129787.29 |
Total Medical Medicare Payment Amount |
99891.98 |
Total Medical Medicare Standardized Payment Amount |
102576.78 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
167 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
185 |
Number Of Beneficiaries Age Greater 84 |
159 |
Number Of Female Beneficiaries |
398 |
Number Of Male Beneficiaries |
280 |
Number Of Non Hispanic White Beneficiaries |
595 |
Number Of Black or African American Beneficiaries |
58 |
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 |
410 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
268 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0568 |