National Provider Identifier [NPI]: |
1689847287 |
Last Name Of The Provider |
KHANDKER |
First Name Of The Provider |
SAMIUR |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12025 NEW DOMINION PKWY APT 208 |
Street Address 2 Of The Provider |
|
City Of The Provider |
RESTON |
Zip Code Of The Provider |
201906265 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
601 |
Number Of Medicare Beneficiaries |
404 |
Total Submitted Charge Amount |
365864 |
Total Medicare Allowed Amount |
72710.28 |
Total Medicare Payment Amount |
56524.35 |
Total Medicare Standardized Payment Amount |
52339.74 |
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 |
24 |
Number Of Medical Services |
601 |
Number Of Medicare Beneficiaries With Medical Services |
404 |
Total Medical Submitted Charge Amount |
365864 |
Total Medical Medicare Allowed Amount |
72710.28 |
Total Medical Medicare Payment Amount |
56524.35 |
Total Medical Medicare Standardized Payment Amount |
52339.74 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
288 |
Number Of Black or African American Beneficiaries |
43 |
Number Of AsianPacific Islander Beneficiaries |
34 |
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
326 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.5851 |