National Provider Identifier [NPI]: |
1386809994 |
Last Name Of The Provider |
ELBASHIR |
First Name Of The Provider |
MOHAMMED |
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 |
7430 2ND AVE |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482022739 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
668 |
Number Of Medicare Beneficiaries |
201 |
Total Submitted Charge Amount |
140868 |
Total Medicare Allowed Amount |
73124.73 |
Total Medicare Payment Amount |
57071.05 |
Total Medicare Standardized Payment Amount |
55503.99 |
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 |
17 |
Number Of Medical Services |
668 |
Number Of Medicare Beneficiaries With Medical Services |
201 |
Total Medical Submitted Charge Amount |
140868 |
Total Medical Medicare Allowed Amount |
73124.73 |
Total Medical Medicare Payment Amount |
57071.05 |
Total Medical Medicare Standardized Payment Amount |
55503.99 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
105 |
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 |
126 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
52 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
3.297 |