National Provider Identifier [NPI]: |
1083649990 |
Last Name Of The Provider |
JALEEL |
First Name Of The Provider |
MAIRAJ |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3249 OAK PARK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BERWYN |
Zip Code Of The Provider |
604023429 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
2871 |
Number Of Medicare Beneficiaries |
580 |
Total Submitted Charge Amount |
414902.15 |
Total Medicare Allowed Amount |
241359.16 |
Total Medicare Payment Amount |
188537.97 |
Total Medicare Standardized Payment Amount |
176185.39 |
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 |
22 |
Number Of Medical Services |
2871 |
Number Of Medicare Beneficiaries With Medical Services |
580 |
Total Medical Submitted Charge Amount |
414902.15 |
Total Medical Medicare Allowed Amount |
241359.16 |
Total Medical Medicare Payment Amount |
188537.97 |
Total Medical Medicare Standardized Payment Amount |
176185.39 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
219 |
Number Of Beneficiaries Age 75 to 84 |
178 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
315 |
Number Of Male Beneficiaries |
265 |
Number Of Non Hispanic White Beneficiaries |
357 |
Number Of Black or African American Beneficiaries |
129 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
76 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
337 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
243 |
Percent Of With Atrial Fibrillation |
40 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
72 |
Percent Of With Chronic Kidney Disease |
73 |
Percent Of With Chronic Obstructive Pulmonary Disease |
63 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
29 |
Average HCC Risk Score Of Beneficiaries |
3.5911 |