National Provider Identifier [NPI]: |
1609998418 |
Last Name Of The Provider |
SIRELKHATIM |
First Name Of The Provider |
ABDELAZIM |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1120 15TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309120004 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1096 |
Number Of Medicare Beneficiaries |
500 |
Total Submitted Charge Amount |
291594 |
Total Medicare Allowed Amount |
136938.89 |
Total Medicare Payment Amount |
104228.93 |
Total Medicare Standardized Payment Amount |
110808.77 |
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 |
22 |
Number Of Medical Services |
1096 |
Number Of Medicare Beneficiaries With Medical Services |
500 |
Total Medical Submitted Charge Amount |
291594 |
Total Medical Medicare Allowed Amount |
136938.89 |
Total Medical Medicare Payment Amount |
104228.93 |
Total Medical Medicare Standardized Payment Amount |
110808.77 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
172 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
268 |
Number Of Male Beneficiaries |
232 |
Number Of Non Hispanic White Beneficiaries |
447 |
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 |
342 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
158 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
69 |
Average HCC Risk Score Of Beneficiaries |
1.7844 |