National Provider Identifier [NPI]: |
1770699175 |
Last Name Of The Provider |
GHAFFAR |
First Name Of The Provider |
EJAZ |
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 |
203 WESTMORELAND CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
KISSIMMEE |
Zip Code Of The Provider |
347445463 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
3454 |
Number Of Medicare Beneficiaries |
706 |
Total Submitted Charge Amount |
299243.24 |
Total Medicare Allowed Amount |
291272.98 |
Total Medicare Payment Amount |
225920.89 |
Total Medicare Standardized Payment Amount |
228781.45 |
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 |
12 |
Number Of Medical Services |
3454 |
Number Of Medicare Beneficiaries With Medical Services |
706 |
Total Medical Submitted Charge Amount |
299243.24 |
Total Medical Medicare Allowed Amount |
291272.98 |
Total Medical Medicare Payment Amount |
225920.89 |
Total Medical Medicare Standardized Payment Amount |
228781.45 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
212 |
Number Of Beneficiaries Age 75 to 84 |
216 |
Number Of Beneficiaries Age Greater 84 |
156 |
Number Of Female Beneficiaries |
395 |
Number Of Male Beneficiaries |
311 |
Number Of Non Hispanic White Beneficiaries |
388 |
Number Of Black or African American Beneficiaries |
73 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
229 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
425 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
281 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.5524 |