National Provider Identifier [NPI]: |
1538324553 |
Last Name Of The Provider |
ZEIDAN |
First Name Of The Provider |
IMAN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 N ATKINSON DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LUDINGTON |
Zip Code Of The Provider |
494311906 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
1104 |
Number Of Medicare Beneficiaries |
388 |
Total Submitted Charge Amount |
186563 |
Total Medicare Allowed Amount |
128387.85 |
Total Medicare Payment Amount |
98433.86 |
Total Medicare Standardized Payment Amount |
101956.77 |
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 |
23 |
Number Of Medical Services |
1104 |
Number Of Medicare Beneficiaries With Medical Services |
388 |
Total Medical Submitted Charge Amount |
186563 |
Total Medical Medicare Allowed Amount |
128387.85 |
Total Medical Medicare Payment Amount |
98433.86 |
Total Medical Medicare Standardized Payment Amount |
101956.77 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
217 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
372 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
272 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
116 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.7205 |