National Provider Identifier [NPI]: |
1568434124 |
Last Name Of The Provider |
KHAN |
First Name Of The Provider |
ILYAS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
414 E SAN BERNARDINO RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
COVINA |
Zip Code Of The Provider |
917231704 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
184 |
Number Of Services |
2626 |
Number Of Medicare Beneficiaries |
1559 |
Total Submitted Charge Amount |
239967 |
Total Medicare Allowed Amount |
85147.83 |
Total Medicare Payment Amount |
66350.77 |
Total Medicare Standardized Payment Amount |
62814.9 |
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 |
184 |
Number Of Medical Services |
2626 |
Number Of Medicare Beneficiaries With Medical Services |
1559 |
Total Medical Submitted Charge Amount |
239967 |
Total Medical Medicare Allowed Amount |
85147.83 |
Total Medical Medicare Payment Amount |
66350.77 |
Total Medical Medicare Standardized Payment Amount |
62814.9 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
287 |
Number Of Beneficiaries Age 65 to 74 |
483 |
Number Of Beneficiaries Age 75 to 84 |
464 |
Number Of Beneficiaries Age Greater 84 |
325 |
Number Of Female Beneficiaries |
946 |
Number Of Male Beneficiaries |
613 |
Number Of Non Hispanic White Beneficiaries |
616 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
156 |
Number Of Hispanic Beneficiaries |
702 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
593 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
966 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.8198 |