National Provider Identifier [NPI]: |
1619318045 |
Last Name Of The Provider |
MALIK |
First Name Of The Provider |
JIMI |
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 |
417 W 3RD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALBANY |
Zip Code Of The Provider |
317011943 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1199 |
Number Of Medicare Beneficiaries |
460 |
Total Submitted Charge Amount |
243129 |
Total Medicare Allowed Amount |
127942.07 |
Total Medicare Payment Amount |
97529.77 |
Total Medicare Standardized Payment Amount |
101695.73 |
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 |
21 |
Number Of Medical Services |
1199 |
Number Of Medicare Beneficiaries With Medical Services |
460 |
Total Medical Submitted Charge Amount |
243129 |
Total Medical Medicare Allowed Amount |
127942.07 |
Total Medical Medicare Payment Amount |
97529.77 |
Total Medical Medicare Standardized Payment Amount |
101695.73 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
88 |
Number Of Female Beneficiaries |
235 |
Number Of Male Beneficiaries |
225 |
Number Of Non Hispanic White Beneficiaries |
305 |
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 |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.2362 |