National Provider Identifier [NPI]: |
1538268289 |
Last Name Of The Provider |
MOUSSALLEM |
First Name Of The Provider |
CHARBEL |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1150 STATE ROUTE 5 AND 20 |
Street Address 2 Of The Provider |
|
City Of The Provider |
GENEVA |
Zip Code Of The Provider |
144569543 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
1174 |
Number Of Medicare Beneficiaries |
329 |
Total Submitted Charge Amount |
156838.3 |
Total Medicare Allowed Amount |
107483.63 |
Total Medicare Payment Amount |
79638.03 |
Total Medicare Standardized Payment Amount |
82926.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
64 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
1491 |
Total Drug Medicare AllowedAmount |
1024.58 |
Total Drug Medicare PaymentAmount |
987.03 |
Total Drug Medicare Standardized Payment Amount |
987.03 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
1110 |
Number Of Medicare Beneficiaries With Medical Services |
329 |
Total Medical Submitted Charge Amount |
155347.3 |
Total Medical Medicare Allowed Amount |
106459.05 |
Total Medical Medicare Payment Amount |
78651 |
Total Medical Medicare Standardized Payment Amount |
81939.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
181 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
308 |
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 |
222 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.8279 |