National Provider Identifier [NPI]: |
1093764193 |
Last Name Of The Provider |
HEYDARPOUR |
First Name Of The Provider |
KAMRAN |
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 |
1 ERIE CT |
Street Address 2 Of The Provider |
SUITE NUMBER 3200 |
City Of The Provider |
OAK PARK |
Zip Code Of The Provider |
603022566 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
1719 |
Number Of Medicare Beneficiaries |
953 |
Total Submitted Charge Amount |
717468 |
Total Medicare Allowed Amount |
284484.58 |
Total Medicare Payment Amount |
229761.4 |
Total Medicare Standardized Payment Amount |
209611.96 |
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 |
44 |
Number Of Medical Services |
1719 |
Number Of Medicare Beneficiaries With Medical Services |
953 |
Total Medical Submitted Charge Amount |
717468 |
Total Medical Medicare Allowed Amount |
284484.58 |
Total Medical Medicare Payment Amount |
229761.4 |
Total Medical Medicare Standardized Payment Amount |
209611.96 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
201 |
Number Of Beneficiaries Age 65 to 74 |
406 |
Number Of Beneficiaries Age 75 to 84 |
244 |
Number Of Beneficiaries Age Greater 84 |
102 |
Number Of Female Beneficiaries |
565 |
Number Of Male Beneficiaries |
388 |
Number Of Non Hispanic White Beneficiaries |
384 |
Number Of Black or African American Beneficiaries |
475 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
551 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
402 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9153 |