National Provider Identifier [NPI]: |
1154634145 |
Last Name Of The Provider |
SAAD |
First Name Of The Provider |
MAGED |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2525 S MICHIGAN AVE |
Street Address 2 Of The Provider |
INTERNAL MEDICINE PROGRAM COORDINATOR |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606162333 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
359 |
Number Of Medicare Beneficiaries |
139 |
Total Submitted Charge Amount |
63393 |
Total Medicare Allowed Amount |
34089.28 |
Total Medicare Payment Amount |
23034.74 |
Total Medicare Standardized Payment Amount |
21980.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
13 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
443 |
Total Drug Medicare AllowedAmount |
214 |
Total Drug Medicare PaymentAmount |
209.74 |
Total Drug Medicare Standardized Payment Amount |
209.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
346 |
Number Of Medicare Beneficiaries With Medical Services |
139 |
Total Medical Submitted Charge Amount |
62950 |
Total Medical Medicare Allowed Amount |
33875.28 |
Total Medical Medicare Payment Amount |
22825 |
Total Medical Medicare Standardized Payment Amount |
21770.47 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
60 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
62 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.6704 |