National Provider Identifier [NPI]: |
1326201666 |
Last Name Of The Provider |
FAROOQ |
First Name Of The Provider |
AHMER |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2160 S 1ST AVE |
Street Address 2 Of The Provider |
DEPARTMENT OF UROLOGY, FAHEY CENTER RM 260 |
City Of The Provider |
MAYWOOD |
Zip Code Of The Provider |
601533328 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
1246 |
Number Of Medicare Beneficiaries |
471 |
Total Submitted Charge Amount |
787028.2 |
Total Medicare Allowed Amount |
142148.39 |
Total Medicare Payment Amount |
107675.59 |
Total Medicare Standardized Payment Amount |
98984.1 |
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 |
73 |
Number Of Medical Services |
1246 |
Number Of Medicare Beneficiaries With Medical Services |
471 |
Total Medical Submitted Charge Amount |
787028.2 |
Total Medical Medicare Allowed Amount |
142148.39 |
Total Medical Medicare Payment Amount |
107675.59 |
Total Medical Medicare Standardized Payment Amount |
98984.1 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
226 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
350 |
Number Of Non Hispanic White Beneficiaries |
321 |
Number Of Black or African American Beneficiaries |
75 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
55 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
375 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
96 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7837 |