National Provider Identifier [NPI]: |
1639270721 |
Last Name Of The Provider |
HABIB |
First Name Of The Provider |
MOAZZAM |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9240 N MERIDIAN ST |
Street Address 2 Of The Provider |
SUITE 240 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462601880 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
3028 |
Number Of Medicare Beneficiaries |
563 |
Total Submitted Charge Amount |
408893 |
Total Medicare Allowed Amount |
303374.42 |
Total Medicare Payment Amount |
226634.6 |
Total Medicare Standardized Payment Amount |
241059.27 |
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 |
16 |
Number Of Medical Services |
3028 |
Number Of Medicare Beneficiaries With Medical Services |
563 |
Total Medical Submitted Charge Amount |
408893 |
Total Medical Medicare Allowed Amount |
303374.42 |
Total Medical Medicare Payment Amount |
226634.6 |
Total Medical Medicare Standardized Payment Amount |
241059.27 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
178 |
Number Of Beneficiaries Age 65 to 74 |
215 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
316 |
Number Of Male Beneficiaries |
247 |
Number Of Non Hispanic White Beneficiaries |
395 |
Number Of Black or African American Beneficiaries |
148 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
346 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
217 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.3434 |