National Provider Identifier [NPI]: |
1205854114 |
Last Name Of The Provider |
REDA |
First Name Of The Provider |
HASSAN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
740 S. LIMESTONE |
Street Address 2 Of The Provider |
A301 |
City Of The Provider |
LEXINGTON |
Zip Code Of The Provider |
405360284 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
330 |
Number Of Medicare Beneficiaries |
118 |
Total Submitted Charge Amount |
603831 |
Total Medicare Allowed Amount |
158350.76 |
Total Medicare Payment Amount |
122731.7 |
Total Medicare Standardized Payment Amount |
132289.59 |
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 |
41 |
Number Of Medical Services |
330 |
Number Of Medicare Beneficiaries With Medical Services |
118 |
Total Medical Submitted Charge Amount |
603831 |
Total Medical Medicare Allowed Amount |
158350.76 |
Total Medical Medicare Payment Amount |
122731.7 |
Total Medical Medicare Standardized Payment Amount |
132289.59 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
44 |
Number Of Male Beneficiaries |
74 |
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 |
74 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
38 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
|
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
72 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
64 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
50 |
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 |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
1.9029 |