National Provider Identifier [NPI]: |
1184801367 |
Last Name Of The Provider |
ABDULLAH |
First Name Of The Provider |
JAVED |
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 |
4250 BETHEL RD |
Street Address 2 Of The Provider |
5TH FLOOR |
City Of The Provider |
OLIVE BRANCH |
Zip Code Of The Provider |
386548737 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
128 |
Number Of Services |
11778 |
Number Of Medicare Beneficiaries |
1738 |
Total Submitted Charge Amount |
2261297.46 |
Total Medicare Allowed Amount |
814238.26 |
Total Medicare Payment Amount |
615492.02 |
Total Medicare Standardized Payment Amount |
685854.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
5810 |
Number Of Medicare Beneficiaries With Drug Services |
214 |
Total Drug Submitted ChargeAmount |
22489.6 |
Total Drug Medicare AllowedAmount |
15618.35 |
Total Drug Medicare PaymentAmount |
12237.23 |
Total Drug Medicare Standardized Payment Amount |
12237.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
121 |
Number Of Medical Services |
5968 |
Number Of Medicare Beneficiaries With Medical Services |
1738 |
Total Medical Submitted Charge Amount |
2238807.86 |
Total Medical Medicare Allowed Amount |
798619.91 |
Total Medical Medicare Payment Amount |
603254.79 |
Total Medical Medicare Standardized Payment Amount |
673616.91 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
459 |
Number Of Beneficiaries Age 65 to 74 |
676 |
Number Of Beneficiaries Age 75 to 84 |
449 |
Number Of Beneficiaries Age Greater 84 |
154 |
Number Of Female Beneficiaries |
910 |
Number Of Male Beneficiaries |
828 |
Number Of Non Hispanic White Beneficiaries |
1436 |
Number Of Black or African American Beneficiaries |
278 |
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 |
958 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
780 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.1264 |