National Provider Identifier [NPI]: |
1104875137 |
Last Name Of The Provider |
HAQUE |
First Name Of The Provider |
UZMA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4940 EASTERN AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212870001 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
345 |
Number Of Medicare Beneficiaries |
123 |
Total Submitted Charge Amount |
68930 |
Total Medicare Allowed Amount |
36524 |
Total Medicare Payment Amount |
26220.8 |
Total Medicare Standardized Payment Amount |
25127.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
916 |
Total Drug Medicare AllowedAmount |
680.08 |
Total Drug Medicare PaymentAmount |
514.16 |
Total Drug Medicare Standardized Payment Amount |
514.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
328 |
Number Of Medicare Beneficiaries With Medical Services |
123 |
Total Medical Submitted Charge Amount |
68014 |
Total Medical Medicare Allowed Amount |
35843.92 |
Total Medical Medicare Payment Amount |
25706.64 |
Total Medical Medicare Standardized Payment Amount |
24613.33 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
49 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
97 |
Number Of Male Beneficiaries |
26 |
Number Of Non Hispanic White Beneficiaries |
89 |
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 |
94 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.6011 |