National Provider Identifier [NPI]: |
1346434743 |
Last Name Of The Provider |
MOHAMED |
First Name Of The Provider |
SHAFI |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1405 CENTERVILLE RD STE 5000 |
Street Address 2 Of The Provider |
|
City Of The Provider |
TALLAHASSEE |
Zip Code Of The Provider |
323084663 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
849 |
Number Of Medicare Beneficiaries |
251 |
Total Submitted Charge Amount |
1287327 |
Total Medicare Allowed Amount |
238226.34 |
Total Medicare Payment Amount |
186488.68 |
Total Medicare Standardized Payment Amount |
178531.17 |
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 |
849 |
Number Of Medicare Beneficiaries With Medical Services |
251 |
Total Medical Submitted Charge Amount |
1287327 |
Total Medical Medicare Allowed Amount |
238226.34 |
Total Medical Medicare Payment Amount |
186488.68 |
Total Medical Medicare Standardized Payment Amount |
178531.17 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
95 |
Number Of Male Beneficiaries |
156 |
Number Of Non Hispanic White Beneficiaries |
195 |
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 |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.9398 |