National Provider Identifier [NPI]: |
1700878600 |
Last Name Of The Provider |
ISA |
First Name Of The Provider |
MUHAMMAD |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
405 W JACKSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CARBONDALE |
Zip Code Of The Provider |
629011462 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
464 |
Number Of Medicare Beneficiaries |
411 |
Total Submitted Charge Amount |
89317.19 |
Total Medicare Allowed Amount |
64982.5 |
Total Medicare Payment Amount |
50854.18 |
Total Medicare Standardized Payment Amount |
50455.98 |
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 |
76 |
Number Of Medical Services |
464 |
Number Of Medicare Beneficiaries With Medical Services |
411 |
Total Medical Submitted Charge Amount |
89317.19 |
Total Medical Medicare Allowed Amount |
64982.5 |
Total Medical Medicare Payment Amount |
50854.18 |
Total Medical Medicare Standardized Payment Amount |
50455.98 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
234 |
Number Of Male Beneficiaries |
177 |
Number Of Non Hispanic White Beneficiaries |
384 |
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 |
268 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
143 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6662 |