National Provider Identifier [NPI]: |
1992766851 |
Last Name Of The Provider |
KHAN |
First Name Of The Provider |
ABDUR |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4221 PLEASANT VALLEY ROAD |
Street Address 2 Of The Provider |
SUITE 114 |
City Of The Provider |
VIRGINIA BEACH |
Zip Code Of The Provider |
234648519 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
782 |
Number Of Medicare Beneficiaries |
185 |
Total Submitted Charge Amount |
96323 |
Total Medicare Allowed Amount |
57560.44 |
Total Medicare Payment Amount |
40003.43 |
Total Medicare Standardized Payment Amount |
41758.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
1200 |
Total Drug Medicare AllowedAmount |
576.77 |
Total Drug Medicare PaymentAmount |
565.19 |
Total Drug Medicare Standardized Payment Amount |
565.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
746 |
Number Of Medicare Beneficiaries With Medical Services |
185 |
Total Medical Submitted Charge Amount |
95123 |
Total Medical Medicare Allowed Amount |
56983.67 |
Total Medical Medicare Payment Amount |
39438.24 |
Total Medical Medicare Standardized Payment Amount |
41193.22 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
85 |
Number Of Non Hispanic White Beneficiaries |
56 |
Number Of Black or African American Beneficiaries |
72 |
Number Of AsianPacific Islander Beneficiaries |
24 |
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
161 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
8 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
19 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7577 |