National Provider Identifier [NPI]: |
1225064322 |
Last Name Of The Provider |
BEG |
First Name Of The Provider |
MIRZA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4024 82ND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ELMHURST |
Zip Code Of The Provider |
113731305 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
5308 |
Number Of Medicare Beneficiaries |
85 |
Total Submitted Charge Amount |
320447 |
Total Medicare Allowed Amount |
144399.06 |
Total Medicare Payment Amount |
111236.13 |
Total Medicare Standardized Payment Amount |
80151.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
66 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
2046 |
Total Drug Medicare AllowedAmount |
674.65 |
Total Drug Medicare PaymentAmount |
531.27 |
Total Drug Medicare Standardized Payment Amount |
531.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
5242 |
Number Of Medicare Beneficiaries With Medical Services |
85 |
Total Medical Submitted Charge Amount |
318401 |
Total Medical Medicare Allowed Amount |
143724.41 |
Total Medical Medicare Payment Amount |
110704.86 |
Total Medical Medicare Standardized Payment Amount |
79620.26 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
39 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0511 |