National Provider Identifier [NPI]: |
1770715625 |
Last Name Of The Provider |
MOHABBAT |
First Name Of The Provider |
ARYA |
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 |
200 1ST ST SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCHESTER |
Zip Code Of The Provider |
559050001 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
661 |
Number Of Medicare Beneficiaries |
286 |
Total Submitted Charge Amount |
61874.37 |
Total Medicare Allowed Amount |
53861.1 |
Total Medicare Payment Amount |
42126.79 |
Total Medicare Standardized Payment Amount |
45420.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
69 |
Number Of Medicare Beneficiaries With Drug Services |
61 |
Total Drug Submitted ChargeAmount |
6787.12 |
Total Drug Medicare AllowedAmount |
6255.92 |
Total Drug Medicare PaymentAmount |
5491.01 |
Total Drug Medicare Standardized Payment Amount |
5491.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
592 |
Number Of Medicare Beneficiaries With Medical Services |
285 |
Total Medical Submitted Charge Amount |
55087.25 |
Total Medical Medicare Allowed Amount |
47605.18 |
Total Medical Medicare Payment Amount |
36635.78 |
Total Medical Medicare Standardized Payment Amount |
39929.47 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
267 |
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 |
246 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6445 |