National Provider Identifier [NPI]: |
1124086012 |
Last Name Of The Provider |
KAYHAN |
First Name Of The Provider |
SHAHROKH |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20201 CRAWFORD AVE |
Street Address 2 Of The Provider |
SUITE 1276 |
City Of The Provider |
OLYMPIA FIELDS |
Zip Code Of The Provider |
604611010 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
1060 |
Number Of Medicare Beneficiaries |
474 |
Total Submitted Charge Amount |
184934 |
Total Medicare Allowed Amount |
144354.29 |
Total Medicare Payment Amount |
106167.13 |
Total Medicare Standardized Payment Amount |
102280.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
84 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
17456.04 |
Total Drug Medicare AllowedAmount |
17443.72 |
Total Drug Medicare PaymentAmount |
13675.9 |
Total Drug Medicare Standardized Payment Amount |
13675.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
976 |
Number Of Medicare Beneficiaries With Medical Services |
474 |
Total Medical Submitted Charge Amount |
167477.96 |
Total Medical Medicare Allowed Amount |
126910.57 |
Total Medical Medicare Payment Amount |
92491.23 |
Total Medical Medicare Standardized Payment Amount |
88604.7 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
194 |
Number Of Beneficiaries Age 75 to 84 |
183 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
111 |
Number Of Male Beneficiaries |
363 |
Number Of Non Hispanic White Beneficiaries |
313 |
Number Of Black or African American Beneficiaries |
133 |
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 |
425 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
28 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.2452 |