National Provider Identifier [NPI]: |
1851313688 |
Last Name Of The Provider |
SHAREEF |
First Name Of The Provider |
MOHAMMED |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
393 EAST TOWN STREET |
Street Address 2 Of The Provider |
SUITE 115 |
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432154761 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1490 |
Number Of Medicare Beneficiaries |
413 |
Total Submitted Charge Amount |
279198 |
Total Medicare Allowed Amount |
142426.76 |
Total Medicare Payment Amount |
110838.51 |
Total Medicare Standardized Payment Amount |
112829.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
560 |
Total Drug Medicare AllowedAmount |
272.69 |
Total Drug Medicare PaymentAmount |
260.31 |
Total Drug Medicare Standardized Payment Amount |
260.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
1473 |
Number Of Medicare Beneficiaries With Medical Services |
413 |
Total Medical Submitted Charge Amount |
278638 |
Total Medical Medicare Allowed Amount |
142154.07 |
Total Medical Medicare Payment Amount |
110578.2 |
Total Medical Medicare Standardized Payment Amount |
112569.66 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
150 |
Number Of Beneficiaries Age 75 to 84 |
101 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
229 |
Number Of Male Beneficiaries |
184 |
Number Of Non Hispanic White Beneficiaries |
327 |
Number Of Black or African American Beneficiaries |
69 |
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 |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
172 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
68 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.7785 |