National Provider Identifier [NPI]: |
1033161435 |
Last Name Of The Provider |
MUHAMMAD |
First Name Of The Provider |
TRACY |
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 |
654 E 47TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606534224 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
879 |
Number Of Medicare Beneficiaries |
261 |
Total Submitted Charge Amount |
89216.04 |
Total Medicare Allowed Amount |
55822.34 |
Total Medicare Payment Amount |
39848.74 |
Total Medicare Standardized Payment Amount |
42053.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
123 |
Number Of Medicare Beneficiaries With Drug Services |
71 |
Total Drug Submitted ChargeAmount |
4815 |
Total Drug Medicare AllowedAmount |
2439.57 |
Total Drug Medicare PaymentAmount |
2263.19 |
Total Drug Medicare Standardized Payment Amount |
2263.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
756 |
Number Of Medicare Beneficiaries With Medical Services |
261 |
Total Medical Submitted Charge Amount |
84401.04 |
Total Medical Medicare Allowed Amount |
53382.77 |
Total Medical Medicare Payment Amount |
37585.55 |
Total Medical Medicare Standardized Payment Amount |
39790.42 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
168 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
197 |
Number Of Black or African American Beneficiaries |
45 |
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 |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2293 |