National Provider Identifier [NPI]: |
1174579148 |
Last Name Of The Provider |
ASLAM |
First Name Of The Provider |
NABEEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4500 SAN PABLO RD S |
Street Address 2 Of The Provider |
PROVIDER ENROLLMENT STABILE NORTH 490 |
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322241865 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Geriatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
4602 |
Number Of Medicare Beneficiaries |
625 |
Total Submitted Charge Amount |
204240.51 |
Total Medicare Allowed Amount |
157338.3 |
Total Medicare Payment Amount |
114117.48 |
Total Medicare Standardized Payment Amount |
126187.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
3210 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
7377.5 |
Total Drug Medicare AllowedAmount |
7016.05 |
Total Drug Medicare PaymentAmount |
5500.6 |
Total Drug Medicare Standardized Payment Amount |
5500.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
1392 |
Number Of Medicare Beneficiaries With Medical Services |
624 |
Total Medical Submitted Charge Amount |
196863.01 |
Total Medical Medicare Allowed Amount |
150322.25 |
Total Medical Medicare Payment Amount |
108616.88 |
Total Medical Medicare Standardized Payment Amount |
120686.78 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
157 |
Number Of Beneficiaries Age 65 to 74 |
226 |
Number Of Beneficiaries Age 75 to 84 |
164 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
272 |
Number Of Male Beneficiaries |
353 |
Number Of Non Hispanic White Beneficiaries |
476 |
Number Of Black or African American Beneficiaries |
107 |
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
529 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
96 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
3.3763 |