National Provider Identifier [NPI]: |
1649219270 |
Last Name Of The Provider |
ALHAMMOURI |
First Name Of The Provider |
MOHAMMED |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5555 W THUNDERBIRD |
Street Address 2 Of The Provider |
BANNER THUNDERBIRD MEDICAL CENTER |
City Of The Provider |
GLENDALE |
Zip Code Of The Provider |
85306 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
652 |
Number Of Medicare Beneficiaries |
193 |
Total Submitted Charge Amount |
246047 |
Total Medicare Allowed Amount |
116465.93 |
Total Medicare Payment Amount |
89803.25 |
Total Medicare Standardized Payment Amount |
89786.4 |
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 |
10 |
Number Of Medical Services |
652 |
Number Of Medicare Beneficiaries With Medical Services |
193 |
Total Medical Submitted Charge Amount |
246047 |
Total Medical Medicare Allowed Amount |
116465.93 |
Total Medical Medicare Payment Amount |
89803.25 |
Total Medical Medicare Standardized Payment Amount |
89786.4 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
151 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
38 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
55 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
3.2265 |