National Provider Identifier [NPI]: |
1700080520 |
Last Name Of The Provider |
GHAZAL |
First Name Of The Provider |
TALAL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2730 UNIVERSITY BLVD W |
Street Address 2 Of The Provider |
SUITE 104 |
City Of The Provider |
WHEATON |
Zip Code Of The Provider |
209021905 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
1916 |
Number Of Medicare Beneficiaries |
329 |
Total Submitted Charge Amount |
900730 |
Total Medicare Allowed Amount |
140902.94 |
Total Medicare Payment Amount |
105207.27 |
Total Medicare Standardized Payment Amount |
97140.58 |
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 |
57 |
Number Of Medical Services |
1916 |
Number Of Medicare Beneficiaries With Medical Services |
329 |
Total Medical Submitted Charge Amount |
900730 |
Total Medical Medicare Allowed Amount |
140902.94 |
Total Medical Medicare Payment Amount |
105207.27 |
Total Medical Medicare Standardized Payment Amount |
97140.58 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
229 |
Number Of Male Beneficiaries |
100 |
Number Of Non Hispanic White Beneficiaries |
223 |
Number Of Black or African American Beneficiaries |
79 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
274 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4364 |