National Provider Identifier [NPI]: |
1215199229 |
Last Name Of The Provider |
MAHMOOD |
First Name Of The Provider |
SHAMAIL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1640 E 13TH ST APT 5 |
Street Address 2 Of The Provider |
|
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741205430 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
504 |
Number Of Medicare Beneficiaries |
446 |
Total Submitted Charge Amount |
210018 |
Total Medicare Allowed Amount |
91103.96 |
Total Medicare Payment Amount |
69825.56 |
Total Medicare Standardized Payment Amount |
70900.55 |
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 |
14 |
Number Of Medical Services |
504 |
Number Of Medicare Beneficiaries With Medical Services |
446 |
Total Medical Submitted Charge Amount |
210018 |
Total Medical Medicare Allowed Amount |
91103.96 |
Total Medical Medicare Payment Amount |
69825.56 |
Total Medical Medicare Standardized Payment Amount |
70900.55 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
255 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
423 |
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 |
278 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.1205 |