National Provider Identifier [NPI]: |
1043531254 |
Last Name Of The Provider |
AHMAD |
First Name Of The Provider |
OMAR |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3651 WHEELER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309096521 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1473 |
Number Of Medicare Beneficiaries |
477 |
Total Submitted Charge Amount |
430117 |
Total Medicare Allowed Amount |
135178.67 |
Total Medicare Payment Amount |
105904.22 |
Total Medicare Standardized Payment Amount |
109454.87 |
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 |
1473 |
Number Of Medicare Beneficiaries With Medical Services |
477 |
Total Medical Submitted Charge Amount |
430117 |
Total Medical Medicare Allowed Amount |
135178.67 |
Total Medical Medicare Payment Amount |
105904.22 |
Total Medical Medicare Standardized Payment Amount |
109454.87 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
109 |
Number Of Female Beneficiaries |
296 |
Number Of Male Beneficiaries |
181 |
Number Of Non Hispanic White Beneficiaries |
337 |
Number Of Black or African American Beneficiaries |
128 |
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 |
318 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
159 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
65 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.2362 |