National Provider Identifier [NPI]: |
1386602431 |
Last Name Of The Provider |
QURESHI |
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 |
6538 CERMAK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BERWYN |
Zip Code Of The Provider |
604022899 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
7518 |
Number Of Medicare Beneficiaries |
685 |
Total Submitted Charge Amount |
1064499.5 |
Total Medicare Allowed Amount |
718255.51 |
Total Medicare Payment Amount |
553708.82 |
Total Medicare Standardized Payment Amount |
519522.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
107 |
Number Of Medicare Beneficiaries With Drug Services |
79 |
Total Drug Submitted ChargeAmount |
3576 |
Total Drug Medicare AllowedAmount |
2323.72 |
Total Drug Medicare PaymentAmount |
2258.42 |
Total Drug Medicare Standardized Payment Amount |
2258.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
7411 |
Number Of Medicare Beneficiaries With Medical Services |
685 |
Total Medical Submitted Charge Amount |
1060923.5 |
Total Medical Medicare Allowed Amount |
715931.79 |
Total Medical Medicare Payment Amount |
551450.4 |
Total Medical Medicare Standardized Payment Amount |
517264.28 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
247 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
366 |
Number Of Male Beneficiaries |
319 |
Number Of Non Hispanic White Beneficiaries |
384 |
Number Of Black or African American Beneficiaries |
138 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
137 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
278 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
407 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
31 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0498 |