National Provider Identifier [NPI]: |
1124059464 |
Last Name Of The Provider |
CHARABATI |
First Name Of The Provider |
JIHAD |
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 |
315 S MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
OLD FORGE |
Zip Code Of The Provider |
185181606 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
912 |
Number Of Medicare Beneficiaries |
168 |
Total Submitted Charge Amount |
98765 |
Total Medicare Allowed Amount |
60255.14 |
Total Medicare Payment Amount |
40427.83 |
Total Medicare Standardized Payment Amount |
42403.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
3125 |
Total Drug Medicare AllowedAmount |
1301.28 |
Total Drug Medicare PaymentAmount |
1270.87 |
Total Drug Medicare Standardized Payment Amount |
1270.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
876 |
Number Of Medicare Beneficiaries With Medical Services |
168 |
Total Medical Submitted Charge Amount |
95640 |
Total Medical Medicare Allowed Amount |
58953.86 |
Total Medical Medicare Payment Amount |
39156.96 |
Total Medical Medicare Standardized Payment Amount |
41132.23 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
86 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.1824 |