National Provider Identifier [NPI]: |
1952375800 |
Last Name Of The Provider |
AHMAD |
First Name Of The Provider |
AMJAD |
Middle Initial Of The Provider |
Z |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1700 E. WEST RD. |
Street Address 2 Of The Provider |
|
City Of The Provider |
CALUMET CITY |
Zip Code Of The Provider |
60409 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
5895 |
Number Of Medicare Beneficiaries |
345 |
Total Submitted Charge Amount |
1333203 |
Total Medicare Allowed Amount |
310759.76 |
Total Medicare Payment Amount |
237576.26 |
Total Medicare Standardized Payment Amount |
207890 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
4701 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
65814 |
Total Drug Medicare AllowedAmount |
25114.3 |
Total Drug Medicare PaymentAmount |
19659.58 |
Total Drug Medicare Standardized Payment Amount |
19659.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
71 |
Number Of Medical Services |
1194 |
Number Of Medicare Beneficiaries With Medical Services |
345 |
Total Medical Submitted Charge Amount |
1267389 |
Total Medical Medicare Allowed Amount |
285645.46 |
Total Medical Medicare Payment Amount |
217916.68 |
Total Medical Medicare Standardized Payment Amount |
188230.42 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
226 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
258 |
Number Of Black or African American Beneficiaries |
40 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
287 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.098 |