National Provider Identifier [NPI]: |
1578684841 |
Last Name Of The Provider |
NAZAM |
First Name Of The Provider |
SAMIR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13037 LEE JACKSON MEMORIAL HWY STE D |
Street Address 2 Of The Provider |
|
City Of The Provider |
FAIRFAX |
Zip Code Of The Provider |
220332004 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
974 |
Number Of Medicare Beneficiaries |
213 |
Total Submitted Charge Amount |
106920 |
Total Medicare Allowed Amount |
71667.66 |
Total Medicare Payment Amount |
48704.29 |
Total Medicare Standardized Payment Amount |
43941.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
605 |
Total Drug Medicare AllowedAmount |
313.93 |
Total Drug Medicare PaymentAmount |
306.36 |
Total Drug Medicare Standardized Payment Amount |
306.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
952 |
Number Of Medicare Beneficiaries With Medical Services |
213 |
Total Medical Submitted Charge Amount |
106315 |
Total Medical Medicare Allowed Amount |
71353.73 |
Total Medical Medicare Payment Amount |
48397.93 |
Total Medical Medicare Standardized Payment Amount |
43635.25 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
174 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
21 |
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 |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9265 |