National Provider Identifier [NPI]: |
1477674232 |
Last Name Of The Provider |
AYYOUB |
First Name Of The Provider |
SHADI |
Middle Initial Of The Provider |
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Credentials Of The Provider |
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Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
975 E 3RD ST |
Street Address 2 Of The Provider |
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City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374032103 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
1167 |
Number Of Medicare Beneficiaries |
393 |
Total Submitted Charge Amount |
240724.11 |
Total Medicare Allowed Amount |
115599.26 |
Total Medicare Payment Amount |
90496.76 |
Total Medicare Standardized Payment Amount |
95017.74 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
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Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
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Total Medical Submitted Charge Amount |
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Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
198 |
Number Of Non Hispanic White Beneficiaries |
330 |
Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
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Number Of Beneficiaries With Medicare Only Entitlement |
230 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
163 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
32 |
Average HCC Risk Score Of Beneficiaries |
2.2054 |