National Provider Identifier [NPI]: |
1992704035 |
Last Name Of The Provider |
ZALZALEH |
First Name Of The Provider |
GHASSAN |
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 |
4400 W 95TH ST |
Street Address 2 Of The Provider |
SUITE 311 |
City Of The Provider |
OAK LAWN |
Zip Code Of The Provider |
604532654 |
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 |
103 |
Number Of Services |
116320 |
Number Of Medicare Beneficiaries |
531 |
Total Submitted Charge Amount |
7104900 |
Total Medicare Allowed Amount |
1801975.34 |
Total Medicare Payment Amount |
1399057.37 |
Total Medicare Standardized Payment Amount |
1381067.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
56 |
Number Of Drug Services |
111416 |
Number Of Medicare Beneficiaries With Drug Services |
134 |
Total Drug Submitted ChargeAmount |
5849080 |
Total Drug Medicare AllowedAmount |
1452253.05 |
Total Drug Medicare PaymentAmount |
1135061.24 |
Total Drug Medicare Standardized Payment Amount |
1135061.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
4904 |
Number Of Medicare Beneficiaries With Medical Services |
517 |
Total Medical Submitted Charge Amount |
1255820 |
Total Medical Medicare Allowed Amount |
349722.29 |
Total Medical Medicare Payment Amount |
263996.13 |
Total Medical Medicare Standardized Payment Amount |
246006.29 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
213 |
Number Of Beneficiaries Age 75 to 84 |
157 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
312 |
Number Of Male Beneficiaries |
219 |
Number Of Non Hispanic White Beneficiaries |
342 |
Number Of Black or African American Beneficiaries |
144 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
27 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
401 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
130 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
39 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.5061 |