National Provider Identifier [NPI]: |
1437272580 |
Last Name Of The Provider |
KARDOUH |
First Name Of The Provider |
YOUSSEF |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16001 W 9 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480754818 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
892 |
Number Of Medicare Beneficiaries |
447 |
Total Submitted Charge Amount |
286748 |
Total Medicare Allowed Amount |
137800.6 |
Total Medicare Payment Amount |
107334.39 |
Total Medicare Standardized Payment Amount |
107993.58 |
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 |
18 |
Number Of Medical Services |
892 |
Number Of Medicare Beneficiaries With Medical Services |
447 |
Total Medical Submitted Charge Amount |
286748 |
Total Medical Medicare Allowed Amount |
137800.6 |
Total Medical Medicare Payment Amount |
107334.39 |
Total Medical Medicare Standardized Payment Amount |
107993.58 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
185 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
206 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
309 |
Number Of Black or African American Beneficiaries |
35 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
56 |
Number Of American Indian Alaska Native Beneficiaries |
35 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
333 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.3058 |