National Provider Identifier [NPI]: |
1578528956 |
Last Name Of The Provider |
ALMOOSA |
First Name Of The Provider |
KHALID |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6431 FANNIN ST |
Street Address 2 Of The Provider |
MSB 1.274 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770301501 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
364 |
Number Of Medicare Beneficiaries |
130 |
Total Submitted Charge Amount |
104675 |
Total Medicare Allowed Amount |
43248.89 |
Total Medicare Payment Amount |
33735.3 |
Total Medicare Standardized Payment Amount |
33520.49 |
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 |
20 |
Number Of Medical Services |
364 |
Number Of Medicare Beneficiaries With Medical Services |
130 |
Total Medical Submitted Charge Amount |
104675 |
Total Medical Medicare Allowed Amount |
43248.89 |
Total Medical Medicare Payment Amount |
33735.3 |
Total Medical Medicare Standardized Payment Amount |
33520.49 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
55 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
77 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
4.1253 |