National Provider Identifier [NPI]: |
1205829991 |
Last Name Of The Provider |
CHAUDHRY |
First Name Of The Provider |
FAISAL |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5705 REDBUD HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
HONAKER |
Zip Code Of The Provider |
24260 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
10754 |
Number Of Medicare Beneficiaries |
487 |
Total Submitted Charge Amount |
707687 |
Total Medicare Allowed Amount |
417461.78 |
Total Medicare Payment Amount |
321895.63 |
Total Medicare Standardized Payment Amount |
330505.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
144 |
Number Of Medicare Beneficiaries With Drug Services |
121 |
Total Drug Submitted ChargeAmount |
3365 |
Total Drug Medicare AllowedAmount |
1689.82 |
Total Drug Medicare PaymentAmount |
1591.33 |
Total Drug Medicare Standardized Payment Amount |
1591.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
10610 |
Number Of Medicare Beneficiaries With Medical Services |
487 |
Total Medical Submitted Charge Amount |
704322 |
Total Medical Medicare Allowed Amount |
415771.96 |
Total Medical Medicare Payment Amount |
320304.3 |
Total Medical Medicare Standardized Payment Amount |
328914.25 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
184 |
Number Of Beneficiaries Age 65 to 74 |
168 |
Number Of Beneficiaries Age 75 to 84 |
96 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
250 |
Number Of Male Beneficiaries |
237 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
323 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
164 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.359 |