National Provider Identifier [NPI]: |
1144430893 |
Last Name Of The Provider |
UDDIN |
First Name Of The Provider |
FATEMA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5201 HARRY HINES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
753907201 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1630 |
Number Of Medicare Beneficiaries |
549 |
Total Submitted Charge Amount |
492195 |
Total Medicare Allowed Amount |
163824.39 |
Total Medicare Payment Amount |
127017.17 |
Total Medicare Standardized Payment Amount |
131730.38 |
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 |
52 |
Number Of Medical Services |
1630 |
Number Of Medicare Beneficiaries With Medical Services |
549 |
Total Medical Submitted Charge Amount |
492195 |
Total Medical Medicare Allowed Amount |
163824.39 |
Total Medical Medicare Payment Amount |
127017.17 |
Total Medical Medicare Standardized Payment Amount |
131730.38 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
190 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
94 |
Number Of Female Beneficiaries |
306 |
Number Of Male Beneficiaries |
243 |
Number Of Non Hispanic White Beneficiaries |
409 |
Number Of Black or African American Beneficiaries |
78 |
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 |
398 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.7183 |