National Provider Identifier [NPI]: |
1013170430 |
Last Name Of The Provider |
KHAN |
First Name Of The Provider |
MUSHKBAR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2340 E 10TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462012008 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
214 |
Number Of Medicare Beneficiaries |
120 |
Total Submitted Charge Amount |
28621 |
Total Medicare Allowed Amount |
13351.88 |
Total Medicare Payment Amount |
9929.4 |
Total Medicare Standardized Payment Amount |
10480.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
808 |
Total Drug Medicare AllowedAmount |
485.39 |
Total Drug Medicare PaymentAmount |
474.14 |
Total Drug Medicare Standardized Payment Amount |
474.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
192 |
Number Of Medicare Beneficiaries With Medical Services |
120 |
Total Medical Submitted Charge Amount |
27813 |
Total Medical Medicare Allowed Amount |
12866.49 |
Total Medical Medicare Payment Amount |
9455.26 |
Total Medical Medicare Standardized Payment Amount |
10006.44 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
65 |
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 |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
96 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9307 |