National Provider Identifier [NPI]: |
1124368345 |
Last Name Of The Provider |
NAZ |
First Name Of The Provider |
TABASSUM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1901 N MACARTHUR BLVD |
Street Address 2 Of The Provider |
HTPN OFFICE |
City Of The Provider |
IRVING |
Zip Code Of The Provider |
750612220 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
330 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
56591 |
Total Medicare Allowed Amount |
29514.59 |
Total Medicare Payment Amount |
22759.27 |
Total Medicare Standardized Payment Amount |
21353.6 |
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 |
13 |
Number Of Medical Services |
330 |
Number Of Medicare Beneficiaries With Medical Services |
151 |
Total Medical Submitted Charge Amount |
56591 |
Total Medical Medicare Allowed Amount |
29514.59 |
Total Medical Medicare Payment Amount |
22759.27 |
Total Medical Medicare Standardized Payment Amount |
21353.6 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
67 |
Number Of Non Hispanic White Beneficiaries |
106 |
Number Of Black or African American Beneficiaries |
31 |
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 |
101 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.0363 |