National Provider Identifier [NPI]: |
1982643540 |
Last Name Of The Provider |
KALIMULLAH |
First Name Of The Provider |
ZEBAA |
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 |
3249 OAK PARK AVE |
Street Address 2 Of The Provider |
EMERGENCY DEPARTMENT |
City Of The Provider |
BERWYN |
Zip Code Of The Provider |
604023429 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
345 |
Number Of Medicare Beneficiaries |
220 |
Total Submitted Charge Amount |
143149 |
Total Medicare Allowed Amount |
44719.3 |
Total Medicare Payment Amount |
34809.04 |
Total Medicare Standardized Payment Amount |
32131.5 |
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 |
18 |
Number Of Medical Services |
345 |
Number Of Medicare Beneficiaries With Medical Services |
220 |
Total Medical Submitted Charge Amount |
143149 |
Total Medical Medicare Allowed Amount |
44719.3 |
Total Medical Medicare Payment Amount |
34809.04 |
Total Medical Medicare Standardized Payment Amount |
32131.5 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
144 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
52 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
115 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.2227 |