National Provider Identifier [NPI]: |
1578634226 |
Last Name Of The Provider |
MUNFAKH |
First Name Of The Provider |
NABIL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11155 DUNN RD |
Street Address 2 Of The Provider |
PROFESSIONAL BLDG ONE STE 209 EAST |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631366150 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
825 |
Number Of Medicare Beneficiaries |
361 |
Total Submitted Charge Amount |
1546682 |
Total Medicare Allowed Amount |
393335.93 |
Total Medicare Payment Amount |
306128.95 |
Total Medicare Standardized Payment Amount |
307515.75 |
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 |
92 |
Number Of Medical Services |
825 |
Number Of Medicare Beneficiaries With Medical Services |
361 |
Total Medical Submitted Charge Amount |
1546682 |
Total Medical Medicare Allowed Amount |
393335.93 |
Total Medical Medicare Payment Amount |
306128.95 |
Total Medical Medicare Standardized Payment Amount |
307515.75 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
158 |
Number Of Male Beneficiaries |
203 |
Number Of Non Hispanic White Beneficiaries |
281 |
Number Of Black or African American Beneficiaries |
|
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 |
267 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
29 |
Percent Of With Heart Failure |
65 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
7 |
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 |
2.2415 |