National Provider Identifier [NPI]: |
1740362094 |
Last Name Of The Provider |
ISSA |
First Name Of The Provider |
ZIAD |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
619 E MASON ST |
Street Address 2 Of The Provider |
SUITE 4P57 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627011034 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Electrophysiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
86 |
Number Of Services |
7592 |
Number Of Medicare Beneficiaries |
1621 |
Total Submitted Charge Amount |
2883211.39 |
Total Medicare Allowed Amount |
732469.84 |
Total Medicare Payment Amount |
550249.8 |
Total Medicare Standardized Payment Amount |
556538.31 |
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 |
86 |
Number Of Medical Services |
7592 |
Number Of Medicare Beneficiaries With Medical Services |
1621 |
Total Medical Submitted Charge Amount |
2883211.39 |
Total Medical Medicare Allowed Amount |
732469.84 |
Total Medical Medicare Payment Amount |
550249.8 |
Total Medical Medicare Standardized Payment Amount |
556538.31 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
468 |
Number Of Beneficiaries Age 75 to 84 |
633 |
Number Of Beneficiaries Age Greater 84 |
405 |
Number Of Female Beneficiaries |
756 |
Number Of Male Beneficiaries |
865 |
Number Of Non Hispanic White Beneficiaries |
1582 |
Number Of Black or African American Beneficiaries |
26 |
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 |
1373 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
248 |
Percent Of With Atrial Fibrillation |
47 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7111 |