National Provider Identifier [NPI]: |
1053345231 |
Last Name Of The Provider |
HADI |
First Name Of The Provider |
BASSAM |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10012 KENNERLY RD |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631282197 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurosurgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
497 |
Number Of Medicare Beneficiaries |
209 |
Total Submitted Charge Amount |
343711.67 |
Total Medicare Allowed Amount |
137167.5 |
Total Medicare Payment Amount |
105807.05 |
Total Medicare Standardized Payment Amount |
103879.56 |
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 |
55 |
Number Of Medical Services |
497 |
Number Of Medicare Beneficiaries With Medical Services |
209 |
Total Medical Submitted Charge Amount |
343711.67 |
Total Medical Medicare Allowed Amount |
137167.5 |
Total Medical Medicare Payment Amount |
105807.05 |
Total Medical Medicare Standardized Payment Amount |
103879.56 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
173 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
1.5527 |