National Provider Identifier [NPI]: |
1578708244 |
Last Name Of The Provider |
KHAWAJA |
First Name Of The Provider |
ZESHAUN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
475 SEAVIEW AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
STATEN ISLAND |
Zip Code Of The Provider |
103053436 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
388 |
Number Of Medicare Beneficiaries |
239 |
Total Submitted Charge Amount |
195493 |
Total Medicare Allowed Amount |
44286.25 |
Total Medicare Payment Amount |
34248.56 |
Total Medicare Standardized Payment Amount |
35036.96 |
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 |
18 |
Number Of Medical Services |
388 |
Number Of Medicare Beneficiaries With Medical Services |
239 |
Total Medical Submitted Charge Amount |
195493 |
Total Medical Medicare Allowed Amount |
44286.25 |
Total Medical Medicare Payment Amount |
34248.56 |
Total Medical Medicare Standardized Payment Amount |
35036.96 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
126 |
Number Of Male Beneficiaries |
113 |
Number Of Non Hispanic White Beneficiaries |
179 |
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 |
174 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
75 |
Average HCC Risk Score Of Beneficiaries |
1.9417 |