National Provider Identifier [NPI]: |
1437316841 |
Last Name Of The Provider |
KADRI |
First Name Of The Provider |
SAMEER |
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 |
525 E 68TH ST # M-528 |
Street Address 2 Of The Provider |
BOX 130 |
City Of The Provider |
NEW YORK |
Zip Code Of The Provider |
100654870 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
175 |
Number Of Medicare Beneficiaries |
73 |
Total Submitted Charge Amount |
107634 |
Total Medicare Allowed Amount |
35444.85 |
Total Medicare Payment Amount |
27788.6 |
Total Medicare Standardized Payment Amount |
23845.05 |
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 |
4 |
Number Of Medical Services |
175 |
Number Of Medicare Beneficiaries With Medical Services |
73 |
Total Medical Submitted Charge Amount |
107634 |
Total Medical Medicare Allowed Amount |
35444.85 |
Total Medical Medicare Payment Amount |
27788.6 |
Total Medical Medicare Standardized Payment Amount |
23845.05 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
20 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
42 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
61 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
29 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
45 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
73 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
52 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
36 |
Average HCC Risk Score Of Beneficiaries |
2.746 |