National Provider Identifier [NPI]: |
1215108303 |
Last Name Of The Provider |
JABBOUR |
First Name Of The Provider |
ELIAS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1515 HOLCOMBE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770304000 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
915 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
330332 |
Total Medicare Allowed Amount |
103599.07 |
Total Medicare Payment Amount |
79086.6 |
Total Medicare Standardized Payment Amount |
79854.5 |
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 |
6 |
Number Of Medical Services |
915 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
330332 |
Total Medical Medicare Allowed Amount |
103599.07 |
Total Medical Medicare Payment Amount |
79086.6 |
Total Medical Medicare Standardized Payment Amount |
79854.5 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
177 |
Number Of Black or African American Beneficiaries |
22 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
204 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
3.6573 |