National Provider Identifier [NPI]: |
1912926320 |
Last Name Of The Provider |
HUSSAIN |
First Name Of The Provider |
SAJJAD |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8433 HARCOURT RD STE 100 |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462602193 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
1826 |
Number Of Medicare Beneficiaries |
704 |
Total Submitted Charge Amount |
1207648 |
Total Medicare Allowed Amount |
331935.81 |
Total Medicare Payment Amount |
247592.19 |
Total Medicare Standardized Payment Amount |
272814.79 |
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 |
99 |
Number Of Medical Services |
1826 |
Number Of Medicare Beneficiaries With Medical Services |
704 |
Total Medical Submitted Charge Amount |
1207648 |
Total Medical Medicare Allowed Amount |
331935.81 |
Total Medical Medicare Payment Amount |
247592.19 |
Total Medical Medicare Standardized Payment Amount |
272814.79 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
298 |
Number Of Beneficiaries Age 75 to 84 |
245 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
310 |
Number Of Male Beneficiaries |
394 |
Number Of Non Hispanic White Beneficiaries |
626 |
Number Of Black or African American Beneficiaries |
59 |
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 |
616 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
88 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8271 |