National Provider Identifier [NPI]: |
1851357586 |
Last Name Of The Provider |
AL-HAMDA |
First Name Of The Provider |
AHMAD |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7956 W JEFFERSON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468044140 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pediatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
4863 |
Number Of Medicare Beneficiaries |
1055 |
Total Submitted Charge Amount |
510135 |
Total Medicare Allowed Amount |
291489.3 |
Total Medicare Payment Amount |
224911.93 |
Total Medicare Standardized Payment Amount |
237423.11 |
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 |
15 |
Number Of Medical Services |
4863 |
Number Of Medicare Beneficiaries With Medical Services |
1055 |
Total Medical Submitted Charge Amount |
510135 |
Total Medical Medicare Allowed Amount |
291489.3 |
Total Medical Medicare Payment Amount |
224911.93 |
Total Medical Medicare Standardized Payment Amount |
237423.11 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
337 |
Number Of Beneficiaries Age 65 to 74 |
314 |
Number Of Beneficiaries Age 75 to 84 |
244 |
Number Of Beneficiaries Age Greater 84 |
160 |
Number Of Female Beneficiaries |
590 |
Number Of Male Beneficiaries |
465 |
Number Of Non Hispanic White Beneficiaries |
695 |
Number Of Black or African American Beneficiaries |
335 |
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 |
514 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
541 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
41 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
29 |
Percent Of With Stroke |
35 |
Average HCC Risk Score Of Beneficiaries |
2.366 |