National Provider Identifier [NPI]: |
1700803541 |
Last Name Of The Provider |
QAZI |
First Name Of The Provider |
QAMARUDDIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2845 GREENBRIER RD |
Street Address 2 Of The Provider |
1ST FLOOR |
City Of The Provider |
GREEN BAY |
Zip Code Of The Provider |
543116519 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
18959 |
Number Of Medicare Beneficiaries |
486 |
Total Submitted Charge Amount |
1500515 |
Total Medicare Allowed Amount |
355685.27 |
Total Medicare Payment Amount |
264674.98 |
Total Medicare Standardized Payment Amount |
279545.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
14821 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
222315 |
Total Drug Medicare AllowedAmount |
55066.38 |
Total Drug Medicare PaymentAmount |
42945.8 |
Total Drug Medicare Standardized Payment Amount |
42945.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
4138 |
Number Of Medicare Beneficiaries With Medical Services |
486 |
Total Medical Submitted Charge Amount |
1278200 |
Total Medical Medicare Allowed Amount |
300618.89 |
Total Medical Medicare Payment Amount |
221729.18 |
Total Medical Medicare Standardized Payment Amount |
236599.35 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
185 |
Number Of Beneficiaries Age 75 to 84 |
147 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
247 |
Number Of Male Beneficiaries |
239 |
Number Of Non Hispanic White Beneficiaries |
433 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
16 |
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
367 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
3.0829 |