National Provider Identifier [NPI]: |
1851482384 |
Last Name Of The Provider |
IQBAL |
First Name Of The Provider |
MALIHA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
615 N MICHIGAN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTH BEND |
Zip Code Of The Provider |
466011033 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
898 |
Number Of Medicare Beneficiaries |
362 |
Total Submitted Charge Amount |
151405 |
Total Medicare Allowed Amount |
92540 |
Total Medicare Payment Amount |
71603.9 |
Total Medicare Standardized Payment Amount |
74779.43 |
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 |
18 |
Number Of Medical Services |
898 |
Number Of Medicare Beneficiaries With Medical Services |
362 |
Total Medical Submitted Charge Amount |
151405 |
Total Medical Medicare Allowed Amount |
92540 |
Total Medical Medicare Payment Amount |
71603.9 |
Total Medical Medicare Standardized Payment Amount |
74779.43 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
201 |
Number Of Male Beneficiaries |
161 |
Number Of Non Hispanic White Beneficiaries |
296 |
Number Of Black or African American Beneficiaries |
52 |
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 |
249 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.9974 |