National Provider Identifier [NPI]: |
1700885902 |
Last Name Of The Provider |
FAHMI |
First Name Of The Provider |
MUNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5801 BREMO RD FL 2 |
Street Address 2 Of The Provider |
|
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232261907 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
936 |
Number Of Medicare Beneficiaries |
529 |
Total Submitted Charge Amount |
168259.07 |
Total Medicare Allowed Amount |
111834.07 |
Total Medicare Payment Amount |
86449.75 |
Total Medicare Standardized Payment Amount |
87897.71 |
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 |
20 |
Number Of Medical Services |
936 |
Number Of Medicare Beneficiaries With Medical Services |
529 |
Total Medical Submitted Charge Amount |
168259.07 |
Total Medical Medicare Allowed Amount |
111834.07 |
Total Medical Medicare Payment Amount |
86449.75 |
Total Medical Medicare Standardized Payment Amount |
87897.71 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
169 |
Number Of Female Beneficiaries |
333 |
Number Of Male Beneficiaries |
196 |
Number Of Non Hispanic White Beneficiaries |
328 |
Number Of Black or African American Beneficiaries |
187 |
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 |
259 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
270 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
58 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.4715 |