National Provider Identifier [NPI]: |
1073551594 |
Last Name Of The Provider |
SHABBIR |
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 |
900 JORIE BLVD |
Street Address 2 Of The Provider |
SUITE 186 |
City Of The Provider |
OAK BROOK |
Zip Code Of The Provider |
605232213 |
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 |
17 |
Number Of Services |
481 |
Number Of Medicare Beneficiaries |
223 |
Total Submitted Charge Amount |
135915 |
Total Medicare Allowed Amount |
56056.01 |
Total Medicare Payment Amount |
43439.81 |
Total Medicare Standardized Payment Amount |
40550.85 |
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 |
481 |
Number Of Medicare Beneficiaries With Medical Services |
223 |
Total Medical Submitted Charge Amount |
135915 |
Total Medical Medicare Allowed Amount |
56056.01 |
Total Medical Medicare Payment Amount |
43439.81 |
Total Medical Medicare Standardized Payment Amount |
40550.85 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
90 |
Number Of Non Hispanic White Beneficiaries |
98 |
Number Of Black or African American Beneficiaries |
113 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
87 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.944 |