National Provider Identifier [NPI]: |
1841334174 |
Last Name Of The Provider |
KHALAF |
First Name Of The Provider |
MAJID |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3800 20TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
VERO BEACH |
Zip Code Of The Provider |
329602412 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
7511 |
Number Of Medicare Beneficiaries |
112 |
Total Submitted Charge Amount |
781803 |
Total Medicare Allowed Amount |
208058.57 |
Total Medicare Payment Amount |
158541.58 |
Total Medicare Standardized Payment Amount |
148768.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
5679 |
Number Of Medicare Beneficiaries With Drug Services |
82 |
Total Drug Submitted ChargeAmount |
18448 |
Total Drug Medicare AllowedAmount |
3079.98 |
Total Drug Medicare PaymentAmount |
2408.82 |
Total Drug Medicare Standardized Payment Amount |
2408.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1832 |
Number Of Medicare Beneficiaries With Medical Services |
112 |
Total Medical Submitted Charge Amount |
763355 |
Total Medical Medicare Allowed Amount |
204978.59 |
Total Medical Medicare Payment Amount |
156132.76 |
Total Medical Medicare Standardized Payment Amount |
146359.76 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
98 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
71 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3924 |