National Provider Identifier [NPI]: |
1124010434 |
Last Name Of The Provider |
QAZI |
First Name Of The Provider |
MUJTABA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1815 CLARKSON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHESTERFIELD |
Zip Code Of The Provider |
630175065 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
3488 |
Number Of Medicare Beneficiaries |
976 |
Total Submitted Charge Amount |
1460249 |
Total Medicare Allowed Amount |
475905.37 |
Total Medicare Payment Amount |
349771.44 |
Total Medicare Standardized Payment Amount |
362569.53 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
502 |
Number Of Beneficiaries Age 75 to 84 |
315 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
599 |
Number Of Male Beneficiaries |
377 |
Number Of Non Hispanic White Beneficiaries |
895 |
Number Of Black or African American Beneficiaries |
32 |
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 |
23 |
Number Of Beneficiaries With Medicare Only Entitlement |
955 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9814 |