National Provider Identifier [NPI]: |
1518909605 |
Last Name Of The Provider |
MALIK |
First Name Of The Provider |
SHAMIM |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2500 RIKE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PINE BLUFF |
Zip Code Of The Provider |
716033937 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
856 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
59539.89 |
Total Medicare Allowed Amount |
56416.82 |
Total Medicare Payment Amount |
37801.59 |
Total Medicare Standardized Payment Amount |
42426.66 |
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 |
9 |
Number Of Medical Services |
856 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
59539.89 |
Total Medical Medicare Allowed Amount |
56416.82 |
Total Medical Medicare Payment Amount |
37801.59 |
Total Medical Medicare Standardized Payment Amount |
42426.66 |
Average Age Of Beneficiaries |
53 |
Number Of Beneficiaries Age Less65 |
190 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
150 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
132 |
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 |
81 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
161 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
69 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
19 |
Percent Of With Schizophrenia Other PsychoticDisorders |
45 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1185 |