National Provider Identifier [NPI]: |
1124071865 |
Last Name Of The Provider |
SAYEGH |
First Name Of The Provider |
KAMIL |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5114 N GLEN PARK PLACE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PEORIA |
Zip Code Of The Provider |
616144686 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
454 |
Number Of Medicare Beneficiaries |
139 |
Total Submitted Charge Amount |
55072 |
Total Medicare Allowed Amount |
26627.79 |
Total Medicare Payment Amount |
19343.73 |
Total Medicare Standardized Payment Amount |
20415.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
702 |
Total Drug Medicare AllowedAmount |
566.72 |
Total Drug Medicare PaymentAmount |
543.78 |
Total Drug Medicare Standardized Payment Amount |
543.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
434 |
Number Of Medicare Beneficiaries With Medical Services |
139 |
Total Medical Submitted Charge Amount |
54370 |
Total Medical Medicare Allowed Amount |
26061.07 |
Total Medical Medicare Payment Amount |
18799.95 |
Total Medical Medicare Standardized Payment Amount |
19871.93 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
82 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
113 |
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 |
104 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2333 |