National Provider Identifier [NPI]: |
1972554251 |
Last Name Of The Provider |
SHEHADEH |
First Name Of The Provider |
AMJAD |
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 |
483 W. SEED FARM RD. |
Street Address 2 Of The Provider |
|
City Of The Provider |
SACATON |
Zip Code Of The Provider |
851470038 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
357 |
Number Of Medicare Beneficiaries |
127 |
Total Submitted Charge Amount |
61324.33 |
Total Medicare Allowed Amount |
20024.85 |
Total Medicare Payment Amount |
15405.03 |
Total Medicare Standardized Payment Amount |
15634.26 |
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 |
13 |
Number Of Medical Services |
357 |
Number Of Medicare Beneficiaries With Medical Services |
127 |
Total Medical Submitted Charge Amount |
61324.33 |
Total Medical Medicare Allowed Amount |
20024.85 |
Total Medical Medicare Payment Amount |
15405.03 |
Total Medical Medicare Standardized Payment Amount |
15634.26 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
11 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
103 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
55 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
24 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
69 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.2198 |