National Provider Identifier [NPI]: |
1861434896 |
Last Name Of The Provider |
KHAN |
First Name Of The Provider |
FARAH |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 S MICHIGAN AVE |
Street Address 2 Of The Provider |
500 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606033211 |
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 |
43 |
Number Of Services |
1756 |
Number Of Medicare Beneficiaries |
190 |
Total Submitted Charge Amount |
295228.22 |
Total Medicare Allowed Amount |
168979.13 |
Total Medicare Payment Amount |
127932.35 |
Total Medicare Standardized Payment Amount |
121101.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
83 |
Number Of Medicare Beneficiaries With Drug Services |
63 |
Total Drug Submitted ChargeAmount |
5980 |
Total Drug Medicare AllowedAmount |
2959.37 |
Total Drug Medicare PaymentAmount |
2900.15 |
Total Drug Medicare Standardized Payment Amount |
2900.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
1673 |
Number Of Medicare Beneficiaries With Medical Services |
190 |
Total Medical Submitted Charge Amount |
289248.22 |
Total Medical Medicare Allowed Amount |
166019.76 |
Total Medical Medicare Payment Amount |
125032.2 |
Total Medical Medicare Standardized Payment Amount |
118201.29 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
102 |
Number Of Black or African American Beneficiaries |
67 |
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 |
131 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.9797 |