National Provider Identifier [NPI]: |
1396954525 |
Last Name Of The Provider |
SAIDOV |
First Name Of The Provider |
ALIK |
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 |
400 W ARBROOK BLVD STE 330 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
760143174 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
749 |
Number Of Medicare Beneficiaries |
176 |
Total Submitted Charge Amount |
365221.42 |
Total Medicare Allowed Amount |
57459.65 |
Total Medicare Payment Amount |
44037.74 |
Total Medicare Standardized Payment Amount |
44877.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
226 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1755 |
Total Drug Medicare AllowedAmount |
55.1 |
Total Drug Medicare PaymentAmount |
42.4 |
Total Drug Medicare Standardized Payment Amount |
42.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
523 |
Number Of Medicare Beneficiaries With Medical Services |
176 |
Total Medical Submitted Charge Amount |
363466.42 |
Total Medical Medicare Allowed Amount |
57404.55 |
Total Medical Medicare Payment Amount |
43995.34 |
Total Medical Medicare Standardized Payment Amount |
44834.88 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
109 |
Number Of Black or African American Beneficiaries |
52 |
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 |
94 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
82 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0747 |