National Provider Identifier [NPI]: |
1346273786 |
Last Name Of The Provider |
KAZIM |
First Name Of The Provider |
HASEEB |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 WATERMAN WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAVARES |
Zip Code Of The Provider |
327785266 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
2601 |
Number Of Medicare Beneficiaries |
766 |
Total Submitted Charge Amount |
493275 |
Total Medicare Allowed Amount |
260677.87 |
Total Medicare Payment Amount |
202055.06 |
Total Medicare Standardized Payment Amount |
205294.53 |
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 |
18 |
Number Of Medical Services |
2601 |
Number Of Medicare Beneficiaries With Medical Services |
766 |
Total Medical Submitted Charge Amount |
493275 |
Total Medical Medicare Allowed Amount |
260677.87 |
Total Medical Medicare Payment Amount |
202055.06 |
Total Medical Medicare Standardized Payment Amount |
205294.53 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
235 |
Number Of Beneficiaries Age 75 to 84 |
227 |
Number Of Beneficiaries Age Greater 84 |
178 |
Number Of Female Beneficiaries |
495 |
Number Of Male Beneficiaries |
271 |
Number Of Non Hispanic White Beneficiaries |
595 |
Number Of Black or African American Beneficiaries |
92 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
564 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
202 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.2613 |