National Provider Identifier [NPI]: |
1255326914 |
Last Name Of The Provider |
SABAR |
First Name Of The Provider |
ROSHAN |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12700 SOUTHFORK RD |
Street Address 2 Of The Provider |
SUITE 105 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631283201 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
913 |
Number Of Medicare Beneficiaries |
239 |
Total Submitted Charge Amount |
93925 |
Total Medicare Allowed Amount |
64064.97 |
Total Medicare Payment Amount |
36885.69 |
Total Medicare Standardized Payment Amount |
37551.45 |
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 |
9 |
Number Of Medical Services |
913 |
Number Of Medicare Beneficiaries With Medical Services |
239 |
Total Medical Submitted Charge Amount |
93925 |
Total Medical Medicare Allowed Amount |
64064.97 |
Total Medical Medicare Payment Amount |
36885.69 |
Total Medical Medicare Standardized Payment Amount |
37551.45 |
Average Age Of Beneficiaries |
85 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
15 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
158 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
219 |
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 |
128 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
59 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
31 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.1471 |