National Provider Identifier [NPI]: |
1174642839 |
Last Name Of The Provider |
ALAM |
First Name Of The Provider |
TARIQ |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12554 RIATA VISTA CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
787276431 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
186 |
Number Of Services |
6039 |
Number Of Medicare Beneficiaries |
3140 |
Total Submitted Charge Amount |
1285495 |
Total Medicare Allowed Amount |
256808.87 |
Total Medicare Payment Amount |
192226.9 |
Total Medicare Standardized Payment Amount |
188417.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
890 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
3596.5 |
Total Drug Medicare AllowedAmount |
637.74 |
Total Drug Medicare PaymentAmount |
482.49 |
Total Drug Medicare Standardized Payment Amount |
482.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
183 |
Number Of Medical Services |
5149 |
Number Of Medicare Beneficiaries With Medical Services |
3140 |
Total Medical Submitted Charge Amount |
1281898.5 |
Total Medical Medicare Allowed Amount |
256171.13 |
Total Medical Medicare Payment Amount |
191744.41 |
Total Medical Medicare Standardized Payment Amount |
187934.62 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
418 |
Number Of Beneficiaries Age 65 to 74 |
1156 |
Number Of Beneficiaries Age 75 to 84 |
1008 |
Number Of Beneficiaries Age Greater 84 |
558 |
Number Of Female Beneficiaries |
1856 |
Number Of Male Beneficiaries |
1284 |
Number Of Non Hispanic White Beneficiaries |
2724 |
Number Of Black or African American Beneficiaries |
102 |
Number Of AsianPacific Islander Beneficiaries |
118 |
Number Of Hispanic Beneficiaries |
153 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2609 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
531 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.5591 |