National Provider Identifier [NPI]: |
1528026465 |
Last Name Of The Provider |
QAYUM |
First Name Of The Provider |
KHALID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12266 DEPAUL DRIVE |
Street Address 2 Of The Provider |
205 |
City Of The Provider |
BRIDGETON |
Zip Code Of The Provider |
63044 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
2396 |
Number Of Medicare Beneficiaries |
1656 |
Total Submitted Charge Amount |
195461 |
Total Medicare Allowed Amount |
65369.49 |
Total Medicare Payment Amount |
50207.12 |
Total Medicare Standardized Payment Amount |
50473.62 |
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 |
26 |
Number Of Medical Services |
2396 |
Number Of Medicare Beneficiaries With Medical Services |
1656 |
Total Medical Submitted Charge Amount |
195461 |
Total Medical Medicare Allowed Amount |
65369.49 |
Total Medical Medicare Payment Amount |
50207.12 |
Total Medical Medicare Standardized Payment Amount |
50473.62 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
396 |
Number Of Beneficiaries Age 65 to 74 |
518 |
Number Of Beneficiaries Age 75 to 84 |
446 |
Number Of Beneficiaries Age Greater 84 |
296 |
Number Of Female Beneficiaries |
943 |
Number Of Male Beneficiaries |
713 |
Number Of Non Hispanic White Beneficiaries |
1128 |
Number Of Black or African American Beneficiaries |
487 |
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
1135 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
521 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.3689 |