National Provider Identifier [NPI]: |
1003816836 |
Last Name Of The Provider |
SOFAT |
First Name Of The Provider |
SHUBIR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15825 SHADY GROVE RD |
Street Address 2 Of The Provider |
SUITE #60 |
City Of The Provider |
ROCKVILLE |
Zip Code Of The Provider |
208504008 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
5500 |
Number Of Medicare Beneficiaries |
1515 |
Total Submitted Charge Amount |
1694901.37 |
Total Medicare Allowed Amount |
569818.08 |
Total Medicare Payment Amount |
436040.01 |
Total Medicare Standardized Payment Amount |
389404.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
508 |
Number Of Medicare Beneficiaries With Drug Services |
127 |
Total Drug Submitted ChargeAmount |
50800 |
Total Drug Medicare AllowedAmount |
26900.13 |
Total Drug Medicare PaymentAmount |
21089.54 |
Total Drug Medicare Standardized Payment Amount |
21089.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
4992 |
Number Of Medicare Beneficiaries With Medical Services |
1515 |
Total Medical Submitted Charge Amount |
1644101.37 |
Total Medical Medicare Allowed Amount |
542917.95 |
Total Medical Medicare Payment Amount |
414950.47 |
Total Medical Medicare Standardized Payment Amount |
368315.34 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
560 |
Number Of Beneficiaries Age 75 to 84 |
470 |
Number Of Beneficiaries Age Greater 84 |
358 |
Number Of Female Beneficiaries |
885 |
Number Of Male Beneficiaries |
630 |
Number Of Non Hispanic White Beneficiaries |
979 |
Number Of Black or African American Beneficiaries |
232 |
Number Of AsianPacific Islander Beneficiaries |
172 |
Number Of Hispanic Beneficiaries |
88 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
44 |
Number Of Beneficiaries With Medicare Only Entitlement |
1108 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
407 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.681 |