National Provider Identifier [NPI]: |
1124299235 |
Last Name Of The Provider |
ELBADAWI |
First Name Of The Provider |
HUSSEIN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4201 SAINT ANTOINE ST |
Street Address 2 Of The Provider |
UHC-SUITE 5A |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482012153 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
161 |
Number Of Medicare Beneficiaries |
68 |
Total Submitted Charge Amount |
22106 |
Total Medicare Allowed Amount |
13327.47 |
Total Medicare Payment Amount |
10382.89 |
Total Medicare Standardized Payment Amount |
9839.61 |
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 |
14 |
Number Of Medical Services |
161 |
Number Of Medicare Beneficiaries With Medical Services |
68 |
Total Medical Submitted Charge Amount |
22106 |
Total Medical Medicare Allowed Amount |
13327.47 |
Total Medical Medicare Payment Amount |
10382.89 |
Total Medical Medicare Standardized Payment Amount |
9839.61 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
18 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
49 |
Number Of Male Beneficiaries |
19 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
56 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
28 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
71 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
3.0854 |