National Provider Identifier [NPI]: |
1730350794 |
Last Name Of The Provider |
KITTANEH |
First Name Of The Provider |
MUAIAD |
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 |
4440 W 95TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
OAK LAWN |
Zip Code Of The Provider |
604532600 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
165 |
Number Of Medicare Beneficiaries |
91 |
Total Submitted Charge Amount |
28146 |
Total Medicare Allowed Amount |
15889.32 |
Total Medicare Payment Amount |
12196.06 |
Total Medicare Standardized Payment Amount |
12045.47 |
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 |
10 |
Number Of Medical Services |
165 |
Number Of Medicare Beneficiaries With Medical Services |
91 |
Total Medical Submitted Charge Amount |
28146 |
Total Medical Medicare Allowed Amount |
15889.32 |
Total Medical Medicare Payment Amount |
12196.06 |
Total Medical Medicare Standardized Payment Amount |
12045.47 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
49 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
68 |
Number Of Black or African American Beneficiaries |
|
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 |
73 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
67 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.8164 |