National Provider Identifier [NPI]: |
1902093545 |
Last Name Of The Provider |
IBRAHIM |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
77 W UNDERWOOD ST |
Street Address 2 Of The Provider |
2ND FLOOR |
City Of The Provider |
ORLANDO |
Zip Code Of The Provider |
328061122 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
71 |
Number Of Services |
706 |
Number Of Medicare Beneficiaries |
312 |
Total Submitted Charge Amount |
308923 |
Total Medicare Allowed Amount |
106202.64 |
Total Medicare Payment Amount |
82934.93 |
Total Medicare Standardized Payment Amount |
81644.61 |
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 |
71 |
Number Of Medical Services |
706 |
Number Of Medicare Beneficiaries With Medical Services |
312 |
Total Medical Submitted Charge Amount |
308923 |
Total Medical Medicare Allowed Amount |
106202.64 |
Total Medical Medicare Payment Amount |
82934.93 |
Total Medical Medicare Standardized Payment Amount |
81644.61 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
157 |
Number Of Non Hispanic White Beneficiaries |
234 |
Number Of Black or African American Beneficiaries |
41 |
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 |
208 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
2.2666 |