National Provider Identifier [NPI]: |
1245277300 |
Last Name Of The Provider |
KASPERKHAN |
First Name Of The Provider |
JIBRAIL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16906 HIDDEN OAK WOODS |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782481403 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
11054 |
Number Of Medicare Beneficiaries |
1057 |
Total Submitted Charge Amount |
1252313.01 |
Total Medicare Allowed Amount |
1052185.19 |
Total Medicare Payment Amount |
798248.47 |
Total Medicare Standardized Payment Amount |
846028.1 |
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 |
19 |
Number Of Medical Services |
11054 |
Number Of Medicare Beneficiaries With Medical Services |
1057 |
Total Medical Submitted Charge Amount |
1252313.01 |
Total Medical Medicare Allowed Amount |
1052185.19 |
Total Medical Medicare Payment Amount |
798248.47 |
Total Medical Medicare Standardized Payment Amount |
846028.1 |
Average Age Of Beneficiaries |
82 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
315 |
Number Of Beneficiaries Age Greater 84 |
492 |
Number Of Female Beneficiaries |
618 |
Number Of Male Beneficiaries |
439 |
Number Of Non Hispanic White Beneficiaries |
731 |
Number Of Black or African American Beneficiaries |
62 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
247 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
531 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
526 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
74 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
27 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.4625 |