National Provider Identifier [NPI]: |
1518056464 |
Last Name Of The Provider |
ISMAIL |
First Name Of The Provider |
ANJUM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2641 W HORIZON RIDGE PKWY |
Street Address 2 Of The Provider |
SUITE 120 |
City Of The Provider |
HENDERSON |
Zip Code Of The Provider |
890524830 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
8812 |
Number Of Medicare Beneficiaries |
755 |
Total Submitted Charge Amount |
1733406 |
Total Medicare Allowed Amount |
746423.1 |
Total Medicare Payment Amount |
558591.85 |
Total Medicare Standardized Payment Amount |
543225.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
818 |
Number Of Medicare Beneficiaries With Drug Services |
207 |
Total Drug Submitted ChargeAmount |
81350 |
Total Drug Medicare AllowedAmount |
43027.37 |
Total Drug Medicare PaymentAmount |
33567.53 |
Total Drug Medicare Standardized Payment Amount |
33567.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
7994 |
Number Of Medicare Beneficiaries With Medical Services |
755 |
Total Medical Submitted Charge Amount |
1652056 |
Total Medical Medicare Allowed Amount |
703395.73 |
Total Medical Medicare Payment Amount |
525024.32 |
Total Medical Medicare Standardized Payment Amount |
509658.02 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
356 |
Number Of Beneficiaries Age 75 to 84 |
268 |
Number Of Beneficiaries Age Greater 84 |
101 |
Number Of Female Beneficiaries |
392 |
Number Of Male Beneficiaries |
363 |
Number Of Non Hispanic White Beneficiaries |
631 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
28 |
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
30 |
Number Of Beneficiaries With Medicare Only Entitlement |
710 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1898 |