National Provider Identifier [NPI]: |
1619094844 |
Last Name Of The Provider |
MOHIUDDIN |
First Name Of The Provider |
ASIM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
901 MACARTHUR BLVD |
Street Address 2 Of The Provider |
ATTN ANESTHESIA |
City Of The Provider |
MUNSTER |
Zip Code Of The Provider |
463212901 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
140 |
Number Of Medicare Beneficiaries |
100 |
Total Submitted Charge Amount |
259221.2 |
Total Medicare Allowed Amount |
37896.35 |
Total Medicare Payment Amount |
29562.42 |
Total Medicare Standardized Payment Amount |
30918.11 |
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 |
42 |
Number Of Medical Services |
140 |
Number Of Medicare Beneficiaries With Medical Services |
100 |
Total Medical Submitted Charge Amount |
259221.2 |
Total Medical Medicare Allowed Amount |
37896.35 |
Total Medical Medicare Payment Amount |
29562.42 |
Total Medical Medicare Standardized Payment Amount |
30918.11 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
48 |
Number Of Black or African American Beneficiaries |
25 |
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.6936 |