National Provider Identifier [NPI]: |
1245404649 |
Last Name Of The Provider |
ABBAS |
First Name Of The Provider |
IBRAHEEM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
733 W CLAIREMONT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
EAU CLAIRE |
Zip Code Of The Provider |
547016101 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
22826 |
Number Of Medicare Beneficiaries |
316 |
Total Submitted Charge Amount |
826986.28 |
Total Medicare Allowed Amount |
252080.11 |
Total Medicare Payment Amount |
189149.81 |
Total Medicare Standardized Payment Amount |
202064.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
21322 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
155676.28 |
Total Drug Medicare AllowedAmount |
62499.87 |
Total Drug Medicare PaymentAmount |
48932.08 |
Total Drug Medicare Standardized Payment Amount |
48932.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
1504 |
Number Of Medicare Beneficiaries With Medical Services |
316 |
Total Medical Submitted Charge Amount |
671310 |
Total Medical Medicare Allowed Amount |
189580.24 |
Total Medical Medicare Payment Amount |
140217.73 |
Total Medical Medicare Standardized Payment Amount |
153132.54 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
167 |
Number Of Non Hispanic White Beneficiaries |
291 |
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 |
209 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
4.1482 |