National Provider Identifier [NPI]: |
1750499596 |
Last Name Of The Provider |
SULTAN |
First Name Of The Provider |
FARAH |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2018 BROOKWOOD MEDICAL CTR DR |
Street Address 2 Of The Provider |
SUITE G-5 PROFESSIONAL OFFICE BLDG |
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
352096898 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
1523 |
Number Of Medicare Beneficiaries |
271 |
Total Submitted Charge Amount |
184042 |
Total Medicare Allowed Amount |
139197.34 |
Total Medicare Payment Amount |
103404.26 |
Total Medicare Standardized Payment Amount |
108190.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
119 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
3400 |
Total Drug Medicare AllowedAmount |
2531.97 |
Total Drug Medicare PaymentAmount |
2247.02 |
Total Drug Medicare Standardized Payment Amount |
2247.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
1404 |
Number Of Medicare Beneficiaries With Medical Services |
271 |
Total Medical Submitted Charge Amount |
180642 |
Total Medical Medicare Allowed Amount |
136665.37 |
Total Medical Medicare Payment Amount |
101157.24 |
Total Medical Medicare Standardized Payment Amount |
105943.23 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
126 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
219 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
196 |
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 |
253 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.2111 |