National Provider Identifier [NPI]: |
1811085152 |
Last Name Of The Provider |
SHERIF |
First Name Of The Provider |
HISHAM |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4755 OGLETOWN STANTON RD |
Street Address 2 Of The Provider |
SUITE 1E50 |
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
198057170 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
243 |
Number Of Medicare Beneficiaries |
136 |
Total Submitted Charge Amount |
1171575.02 |
Total Medicare Allowed Amount |
59465.06 |
Total Medicare Payment Amount |
46505.14 |
Total Medicare Standardized Payment Amount |
46553.99 |
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 |
28 |
Number Of Medical Services |
243 |
Number Of Medicare Beneficiaries With Medical Services |
136 |
Total Medical Submitted Charge Amount |
1171575.02 |
Total Medical Medicare Allowed Amount |
59465.06 |
Total Medical Medicare Payment Amount |
46505.14 |
Total Medical Medicare Standardized Payment Amount |
46553.99 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
45 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
118 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
118 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
41 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6498 |