National Provider Identifier [NPI]: |
1740284710 |
Last Name Of The Provider |
AWAD |
First Name Of The Provider |
KETTI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6624 FANNIN ST |
Street Address 2 Of The Provider |
SUITE 1210 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770302312 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
390 |
Number Of Medicare Beneficiaries |
113 |
Total Submitted Charge Amount |
44009.61 |
Total Medicare Allowed Amount |
27316.28 |
Total Medicare Payment Amount |
21755.77 |
Total Medicare Standardized Payment Amount |
22851.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
46 |
Number Of Medicare Beneficiaries With Drug Services |
42 |
Total Drug Submitted ChargeAmount |
3002.85 |
Total Drug Medicare AllowedAmount |
1657.2 |
Total Drug Medicare PaymentAmount |
1624.01 |
Total Drug Medicare Standardized Payment Amount |
1624.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
344 |
Number Of Medicare Beneficiaries With Medical Services |
113 |
Total Medical Submitted Charge Amount |
41006.76 |
Total Medical Medicare Allowed Amount |
25659.08 |
Total Medical Medicare Payment Amount |
20131.76 |
Total Medical Medicare Standardized Payment Amount |
21227.74 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
86 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8574 |