National Provider Identifier [NPI]: |
1508814021 |
Last Name Of The Provider |
IQBAL |
First Name Of The Provider |
SABAHAT |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5175 E MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432132425 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1540 |
Number Of Medicare Beneficiaries |
483 |
Total Submitted Charge Amount |
293200 |
Total Medicare Allowed Amount |
147200.43 |
Total Medicare Payment Amount |
112397.36 |
Total Medicare Standardized Payment Amount |
115633.84 |
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 |
35 |
Number Of Medical Services |
1540 |
Number Of Medicare Beneficiaries With Medical Services |
483 |
Total Medical Submitted Charge Amount |
293200 |
Total Medical Medicare Allowed Amount |
147200.43 |
Total Medical Medicare Payment Amount |
112397.36 |
Total Medical Medicare Standardized Payment Amount |
115633.84 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
109 |
Number Of Beneficiaries Age Greater 84 |
153 |
Number Of Female Beneficiaries |
301 |
Number Of Male Beneficiaries |
182 |
Number Of Non Hispanic White Beneficiaries |
301 |
Number Of Black or African American Beneficiaries |
171 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
296 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
187 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.404 |