National Provider Identifier [NPI]: |
1730265695 |
Last Name Of The Provider |
HAIDAR |
First Name Of The Provider |
WAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4439 STATE ROUTE 159 |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
CHILLICOTHE |
Zip Code Of The Provider |
456018207 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
980 |
Number Of Medicare Beneficiaries |
259 |
Total Submitted Charge Amount |
176651 |
Total Medicare Allowed Amount |
100650.34 |
Total Medicare Payment Amount |
77270.63 |
Total Medicare Standardized Payment Amount |
79552.63 |
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 |
14 |
Number Of Medical Services |
980 |
Number Of Medicare Beneficiaries With Medical Services |
259 |
Total Medical Submitted Charge Amount |
176651 |
Total Medical Medicare Allowed Amount |
100650.34 |
Total Medical Medicare Payment Amount |
77270.63 |
Total Medical Medicare Standardized Payment Amount |
79552.63 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
120 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
71 |
Percent Of With Chronic Obstructive Pulmonary Disease |
61 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
3.0291 |