National Provider Identifier [NPI]: |
1396763645 |
Last Name Of The Provider |
HUSSEIN |
First Name Of The Provider |
RAFID |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
28 S MOUNT AUBURN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CAPE GIRARDEAU |
Zip Code Of The Provider |
637034914 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
1730 |
Number Of Medicare Beneficiaries |
630 |
Total Submitted Charge Amount |
1664134 |
Total Medicare Allowed Amount |
234041.37 |
Total Medicare Payment Amount |
176650.62 |
Total Medicare Standardized Payment Amount |
191232.89 |
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 |
41 |
Number Of Medical Services |
1730 |
Number Of Medicare Beneficiaries With Medical Services |
630 |
Total Medical Submitted Charge Amount |
1664134 |
Total Medical Medicare Allowed Amount |
234041.37 |
Total Medical Medicare Payment Amount |
176650.62 |
Total Medical Medicare Standardized Payment Amount |
191232.89 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
185 |
Number Of Beneficiaries Age 65 to 74 |
221 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
259 |
Number Of Non Hispanic White Beneficiaries |
574 |
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 |
407 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
223 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.578 |