National Provider Identifier [NPI]: |
1447310677 |
Last Name Of The Provider |
HABIB-HONG |
First Name Of The Provider |
SALEHA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
120 SISTER PIERRE DR |
Street Address 2 Of The Provider |
SUITE 306 |
City Of The Provider |
TOWSON |
Zip Code Of The Provider |
212047516 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
530 |
Number Of Medicare Beneficiaries |
117 |
Total Submitted Charge Amount |
62250 |
Total Medicare Allowed Amount |
39803.38 |
Total Medicare Payment Amount |
28845.51 |
Total Medicare Standardized Payment Amount |
27233.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
14 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
580 |
Total Drug Medicare AllowedAmount |
459.9 |
Total Drug Medicare PaymentAmount |
450.67 |
Total Drug Medicare Standardized Payment Amount |
450.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
516 |
Number Of Medicare Beneficiaries With Medical Services |
117 |
Total Medical Submitted Charge Amount |
61670 |
Total Medical Medicare Allowed Amount |
39343.48 |
Total Medical Medicare Payment Amount |
28394.84 |
Total Medical Medicare Standardized Payment Amount |
26782.44 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
106 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
26 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9164 |