National Provider Identifier [NPI]: |
1043465586 |
Last Name Of The Provider |
RAHMAN |
First Name Of The Provider |
SABA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 ELIZABETH PL |
Street Address 2 Of The Provider |
NWG SUITE 500 |
City Of The Provider |
DAYTON |
Zip Code Of The Provider |
454081445 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
252 |
Number Of Medicare Beneficiaries |
245 |
Total Submitted Charge Amount |
133645 |
Total Medicare Allowed Amount |
39332.68 |
Total Medicare Payment Amount |
30722.31 |
Total Medicare Standardized Payment Amount |
30449.49 |
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 |
11 |
Number Of Medical Services |
252 |
Number Of Medicare Beneficiaries With Medical Services |
245 |
Total Medical Submitted Charge Amount |
133645 |
Total Medical Medicare Allowed Amount |
39332.68 |
Total Medical Medicare Payment Amount |
30722.31 |
Total Medical Medicare Standardized Payment Amount |
30449.49 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
210 |
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 |
169 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
1.9409 |