National Provider Identifier [NPI]: |
1902812902 |
Last Name Of The Provider |
MAHMOUD |
First Name Of The Provider |
LIRIO |
Middle Initial Of The Provider |
U |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
373 W 101ST TER |
Street Address 2 Of The Provider |
|
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
641144408 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
1652 |
Number Of Medicare Beneficiaries |
127 |
Total Submitted Charge Amount |
98927 |
Total Medicare Allowed Amount |
57971.19 |
Total Medicare Payment Amount |
48073.34 |
Total Medicare Standardized Payment Amount |
49619.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
70 |
Number Of Medicare Beneficiaries With Drug Services |
59 |
Total Drug Submitted ChargeAmount |
3104 |
Total Drug Medicare AllowedAmount |
2083.89 |
Total Drug Medicare PaymentAmount |
2030 |
Total Drug Medicare Standardized Payment Amount |
2030 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
72 |
Number Of Medical Services |
1582 |
Number Of Medicare Beneficiaries With Medical Services |
127 |
Total Medical Submitted Charge Amount |
95823 |
Total Medical Medicare Allowed Amount |
55887.3 |
Total Medical Medicare Payment Amount |
46043.34 |
Total Medical Medicare Standardized Payment Amount |
47589.23 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
69 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.106 |