National Provider Identifier [NPI]: |
1669585956 |
Last Name Of The Provider |
YUSAF |
First Name Of The Provider |
OMER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2400 N ROCKTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKFORD |
Zip Code Of The Provider |
611033655 |
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 |
24 |
Number Of Services |
1653 |
Number Of Medicare Beneficiaries |
544 |
Total Submitted Charge Amount |
260971 |
Total Medicare Allowed Amount |
164551.03 |
Total Medicare Payment Amount |
125713.74 |
Total Medicare Standardized Payment Amount |
131101.41 |
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 |
24 |
Number Of Medical Services |
1653 |
Number Of Medicare Beneficiaries With Medical Services |
544 |
Total Medical Submitted Charge Amount |
260971 |
Total Medical Medicare Allowed Amount |
164551.03 |
Total Medical Medicare Payment Amount |
125713.74 |
Total Medical Medicare Standardized Payment Amount |
131101.41 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
143 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
230 |
Number Of Non Hispanic White Beneficiaries |
435 |
Number Of Black or African American Beneficiaries |
83 |
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 |
339 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
205 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.315 |