National Provider Identifier [NPI]: |
1164452058 |
Last Name Of The Provider |
TAHA |
First Name Of The Provider |
MOHAMMAD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
KU MEDICAL CENTER DIV OG GENERAL & |
Street Address 2 Of The Provider |
3901 RAINBOW BLVD, MS 1020 |
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
661600001 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1007 |
Number Of Medicare Beneficiaries |
317 |
Total Submitted Charge Amount |
245775 |
Total Medicare Allowed Amount |
93410.88 |
Total Medicare Payment Amount |
72283.39 |
Total Medicare Standardized Payment Amount |
75656.61 |
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 |
1007 |
Number Of Medicare Beneficiaries With Medical Services |
317 |
Total Medical Submitted Charge Amount |
245775 |
Total Medical Medicare Allowed Amount |
93410.88 |
Total Medical Medicare Payment Amount |
72283.39 |
Total Medical Medicare Standardized Payment Amount |
75656.61 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
246 |
Number Of Black or African American Beneficiaries |
54 |
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 |
200 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.9384 |