National Provider Identifier [NPI]: |
1326011354 |
Last Name Of The Provider |
RAHMAN |
First Name Of The Provider |
ANWER |
Middle Initial Of The Provider |
Z |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12303 DE PAUL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRIDGETON |
Zip Code Of The Provider |
630442512 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
2061 |
Number Of Medicare Beneficiaries |
532 |
Total Submitted Charge Amount |
434915 |
Total Medicare Allowed Amount |
218233.12 |
Total Medicare Payment Amount |
170130.06 |
Total Medicare Standardized Payment Amount |
171728.11 |
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 |
19 |
Number Of Medical Services |
2061 |
Number Of Medicare Beneficiaries With Medical Services |
532 |
Total Medical Submitted Charge Amount |
434915 |
Total Medical Medicare Allowed Amount |
218233.12 |
Total Medical Medicare Payment Amount |
170130.06 |
Total Medical Medicare Standardized Payment Amount |
171728.11 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
148 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
122 |
Number Of Female Beneficiaries |
337 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
302 |
Number Of Black or African American Beneficiaries |
|
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 |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
219 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
3.1252 |