National Provider Identifier [NPI]: |
1417912262 |
Last Name Of The Provider |
ATTA |
First Name Of The Provider |
MOHAMED |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 N WOLFE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212870005 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1394 |
Number Of Medicare Beneficiaries |
390 |
Total Submitted Charge Amount |
488586 |
Total Medicare Allowed Amount |
159535.52 |
Total Medicare Payment Amount |
122973.24 |
Total Medicare Standardized Payment Amount |
117783.82 |
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 |
1394 |
Number Of Medicare Beneficiaries With Medical Services |
390 |
Total Medical Submitted Charge Amount |
488586 |
Total Medical Medicare Allowed Amount |
159535.52 |
Total Medical Medicare Payment Amount |
122973.24 |
Total Medical Medicare Standardized Payment Amount |
117783.82 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
174 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
165 |
Number Of Male Beneficiaries |
225 |
Number Of Non Hispanic White Beneficiaries |
139 |
Number Of Black or African American Beneficiaries |
225 |
Number Of AsianPacific Islander Beneficiaries |
15 |
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 |
217 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
173 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
65 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
5.8161 |