National Provider Identifier [NPI]: |
1174732846 |
Last Name Of The Provider |
ALLAM |
First Name Of The Provider |
MOHAMAD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
155 HOSPITAL DR #301 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAFAYETTE |
Zip Code Of The Provider |
705032846 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
138 |
Number Of Services |
1196 |
Number Of Medicare Beneficiaries |
421 |
Total Submitted Charge Amount |
2014680 |
Total Medicare Allowed Amount |
551268.89 |
Total Medicare Payment Amount |
421038.5 |
Total Medicare Standardized Payment Amount |
447494.96 |
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 |
138 |
Number Of Medical Services |
1196 |
Number Of Medicare Beneficiaries With Medical Services |
421 |
Total Medical Submitted Charge Amount |
2014680 |
Total Medical Medicare Allowed Amount |
551268.89 |
Total Medical Medicare Payment Amount |
421038.5 |
Total Medical Medicare Standardized Payment Amount |
447494.96 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
168 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
190 |
Number Of Male Beneficiaries |
231 |
Number Of Non Hispanic White Beneficiaries |
311 |
Number Of Black or African American Beneficiaries |
92 |
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 |
303 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.788 |