National Provider Identifier [NPI]: |
1518127927 |
Last Name Of The Provider |
MADHOUN |
First Name Of The Provider |
MAZEN |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2001 CRYSTAL SPRING AVE SW |
Street Address 2 Of The Provider |
SUITE 302 |
City Of The Provider |
ROANOKE |
Zip Code Of The Provider |
240142462 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
3501 |
Number Of Medicare Beneficiaries |
1214 |
Total Submitted Charge Amount |
498128 |
Total Medicare Allowed Amount |
371525.25 |
Total Medicare Payment Amount |
280667.86 |
Total Medicare Standardized Payment Amount |
287199.41 |
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 |
25 |
Number Of Medical Services |
3501 |
Number Of Medicare Beneficiaries With Medical Services |
1214 |
Total Medical Submitted Charge Amount |
498128 |
Total Medical Medicare Allowed Amount |
371525.25 |
Total Medical Medicare Payment Amount |
280667.86 |
Total Medical Medicare Standardized Payment Amount |
287199.41 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
288 |
Number Of Beneficiaries Age 75 to 84 |
387 |
Number Of Beneficiaries Age Greater 84 |
421 |
Number Of Female Beneficiaries |
765 |
Number Of Male Beneficiaries |
449 |
Number Of Non Hispanic White Beneficiaries |
1123 |
Number Of Black or African American Beneficiaries |
74 |
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 |
742 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
472 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.0923 |