National Provider Identifier [NPI]: |
1811997380 |
Last Name Of The Provider |
LAKHO |
First Name Of The Provider |
MAZHAR |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4600 MEMORIAL DR |
Street Address 2 Of The Provider |
STE 310 |
City Of The Provider |
BELLEVILLE |
Zip Code Of The Provider |
622265366 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
5068 |
Number Of Medicare Beneficiaries |
472 |
Total Submitted Charge Amount |
468661.5 |
Total Medicare Allowed Amount |
304387.35 |
Total Medicare Payment Amount |
224873.46 |
Total Medicare Standardized Payment Amount |
222867.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
254 |
Number Of Medicare Beneficiaries With Drug Services |
119 |
Total Drug Submitted ChargeAmount |
5625 |
Total Drug Medicare AllowedAmount |
1956.46 |
Total Drug Medicare PaymentAmount |
1829.74 |
Total Drug Medicare Standardized Payment Amount |
1829.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
4814 |
Number Of Medicare Beneficiaries With Medical Services |
472 |
Total Medical Submitted Charge Amount |
463036.5 |
Total Medical Medicare Allowed Amount |
302430.89 |
Total Medical Medicare Payment Amount |
223043.72 |
Total Medical Medicare Standardized Payment Amount |
221037.87 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
190 |
Number Of Non Hispanic White Beneficiaries |
321 |
Number Of Black or African American Beneficiaries |
139 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
322 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
150 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.987 |