National Provider Identifier [NPI]: |
1174635940 |
Last Name Of The Provider |
JAMIL |
First Name Of The Provider |
MOHAMMAD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2837 S HALSTED ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
60608 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
2105 |
Number Of Medicare Beneficiaries |
1083 |
Total Submitted Charge Amount |
117870.81 |
Total Medicare Allowed Amount |
90064.03 |
Total Medicare Payment Amount |
64049.19 |
Total Medicare Standardized Payment Amount |
60388.56 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
198 |
Number Of Beneficiaries Age 65 to 74 |
344 |
Number Of Beneficiaries Age 75 to 84 |
315 |
Number Of Beneficiaries Age Greater 84 |
226 |
Number Of Female Beneficiaries |
662 |
Number Of Male Beneficiaries |
421 |
Number Of Non Hispanic White Beneficiaries |
183 |
Number Of Black or African American Beneficiaries |
750 |
Number Of AsianPacific Islander Beneficiaries |
76 |
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 |
448 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
635 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.3055 |