National Provider Identifier [NPI]: |
1366649626 |
Last Name Of The Provider |
MOHAMED |
First Name Of The Provider |
YASSER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
70 E MAIN ST |
Street Address 2 Of The Provider |
SUITE C |
City Of The Provider |
GREENWOOD |
Zip Code Of The Provider |
461431393 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1258 |
Number Of Medicare Beneficiaries |
413 |
Total Submitted Charge Amount |
441081 |
Total Medicare Allowed Amount |
115272.08 |
Total Medicare Payment Amount |
89991.09 |
Total Medicare Standardized Payment Amount |
93884.96 |
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 |
22 |
Number Of Medical Services |
1258 |
Number Of Medicare Beneficiaries With Medical Services |
413 |
Total Medical Submitted Charge Amount |
441081 |
Total Medical Medicare Allowed Amount |
115272.08 |
Total Medical Medicare Payment Amount |
89991.09 |
Total Medical Medicare Standardized Payment Amount |
93884.96 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
254 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
391 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
289 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.083 |