National Provider Identifier [NPI]: |
1275713935 |
Last Name Of The Provider |
KHOKHAR |
First Name Of The Provider |
UBAID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1200 RIVERPLACE BLVD |
Street Address 2 Of The Provider |
SUITE 620 |
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322079046 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
758 |
Number Of Medicare Beneficiaries |
200 |
Total Submitted Charge Amount |
153727 |
Total Medicare Allowed Amount |
76425.84 |
Total Medicare Payment Amount |
58837.55 |
Total Medicare Standardized Payment Amount |
59266.55 |
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 |
12 |
Number Of Medical Services |
758 |
Number Of Medicare Beneficiaries With Medical Services |
200 |
Total Medical Submitted Charge Amount |
153727 |
Total Medical Medicare Allowed Amount |
76425.84 |
Total Medical Medicare Payment Amount |
58837.55 |
Total Medical Medicare Standardized Payment Amount |
59266.55 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
106 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
164 |
Number Of Black or African American Beneficiaries |
24 |
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 |
85 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
52 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9096 |