National Provider Identifier [NPI]: |
1417193087 |
Last Name Of The Provider |
POOSTIZADEH |
First Name Of The Provider |
MOHAMMAD |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
245 CHERRY ST SE |
Street Address 2 Of The Provider |
STE 104 |
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
49503 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
375 |
Number Of Medicare Beneficiaries |
196 |
Total Submitted Charge Amount |
235544 |
Total Medicare Allowed Amount |
43911.72 |
Total Medicare Payment Amount |
32488.35 |
Total Medicare Standardized Payment Amount |
33318.02 |
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 |
26 |
Number Of Medical Services |
375 |
Number Of Medicare Beneficiaries With Medical Services |
196 |
Total Medical Submitted Charge Amount |
235544 |
Total Medical Medicare Allowed Amount |
43911.72 |
Total Medical Medicare Payment Amount |
32488.35 |
Total Medical Medicare Standardized Payment Amount |
33318.02 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
159 |
Number Of Black or African American Beneficiaries |
|
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 |
93 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
1.6653 |