National Provider Identifier [NPI]: |
1336198209 |
Last Name Of The Provider |
CHAHLAVI |
First Name Of The Provider |
ALI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4205 BELFORT RD |
Street Address 2 Of The Provider |
JOE ADAMS BUILDING SUITE 1100 |
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322165876 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurosurgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
1361 |
Number Of Medicare Beneficiaries |
343 |
Total Submitted Charge Amount |
1963219 |
Total Medicare Allowed Amount |
580159.07 |
Total Medicare Payment Amount |
439936.69 |
Total Medicare Standardized Payment Amount |
400088.44 |
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 |
79 |
Number Of Medical Services |
1361 |
Number Of Medicare Beneficiaries With Medical Services |
343 |
Total Medical Submitted Charge Amount |
1963219 |
Total Medical Medicare Allowed Amount |
580159.07 |
Total Medical Medicare Payment Amount |
439936.69 |
Total Medical Medicare Standardized Payment Amount |
400088.44 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
84 |
Number Of Beneficiaries Age 65 to 74 |
155 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
198 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
295 |
Number Of Black or African American Beneficiaries |
32 |
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 |
75 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.4522 |