National Provider Identifier [NPI]: |
1114243888 |
Last Name Of The Provider |
SHOUKAT |
First Name Of The Provider |
SANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
69 JESSE HILL JR DR SE STE 209 |
Street Address 2 Of The Provider |
GLENN BUILDING, 2ND FLOOR |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303033033 |
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 |
17 |
Number Of Services |
1169 |
Number Of Medicare Beneficiaries |
449 |
Total Submitted Charge Amount |
365457 |
Total Medicare Allowed Amount |
136814.56 |
Total Medicare Payment Amount |
105718.56 |
Total Medicare Standardized Payment Amount |
109809.42 |
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 |
17 |
Number Of Medical Services |
1169 |
Number Of Medicare Beneficiaries With Medical Services |
449 |
Total Medical Submitted Charge Amount |
365457 |
Total Medical Medicare Allowed Amount |
136814.56 |
Total Medical Medicare Payment Amount |
105718.56 |
Total Medical Medicare Standardized Payment Amount |
109809.42 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
250 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
317 |
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 |
243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
206 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.5299 |