National Provider Identifier [NPI]: |
1356427850 |
Last Name Of The Provider |
KABAKIBOU |
First Name Of The Provider |
KAMAL |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3193 HOWELL MILL RD NW |
Street Address 2 Of The Provider |
STE. #317 |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303272119 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
48888 |
Number Of Medicare Beneficiaries |
830 |
Total Submitted Charge Amount |
4017352.11 |
Total Medicare Allowed Amount |
1314452.65 |
Total Medicare Payment Amount |
1157826.3 |
Total Medicare Standardized Payment Amount |
975272.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
9923 |
Number Of Medicare Beneficiaries With Drug Services |
178 |
Total Drug Submitted ChargeAmount |
122000.16 |
Total Drug Medicare AllowedAmount |
28089.73 |
Total Drug Medicare PaymentAmount |
20112.29 |
Total Drug Medicare Standardized Payment Amount |
20112.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
73 |
Number Of Medical Services |
38965 |
Number Of Medicare Beneficiaries With Medical Services |
830 |
Total Medical Submitted Charge Amount |
3895351.95 |
Total Medical Medicare Allowed Amount |
1286362.92 |
Total Medical Medicare Payment Amount |
1137714.01 |
Total Medical Medicare Standardized Payment Amount |
955160.21 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
477 |
Number Of Beneficiaries Age 65 to 74 |
249 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
481 |
Number Of Male Beneficiaries |
349 |
Number Of Non Hispanic White Beneficiaries |
684 |
Number Of Black or African American Beneficiaries |
126 |
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 |
511 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
319 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2849 |