National Provider Identifier [NPI]: |
1700888328 |
Last Name Of The Provider |
EL-GHOROURY |
First Name Of The Provider |
MOHAMED |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22201 MOROSS RD |
Street Address 2 Of The Provider |
STE 170 |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482362169 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
8672 |
Number Of Medicare Beneficiaries |
765 |
Total Submitted Charge Amount |
592505 |
Total Medicare Allowed Amount |
417202.61 |
Total Medicare Payment Amount |
319211.44 |
Total Medicare Standardized Payment Amount |
311470.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
5446 |
Number Of Medicare Beneficiaries With Drug Services |
79 |
Total Drug Submitted ChargeAmount |
23231 |
Total Drug Medicare AllowedAmount |
21225.75 |
Total Drug Medicare PaymentAmount |
16568.42 |
Total Drug Medicare Standardized Payment Amount |
16568.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
3226 |
Number Of Medicare Beneficiaries With Medical Services |
765 |
Total Medical Submitted Charge Amount |
569274 |
Total Medical Medicare Allowed Amount |
395976.86 |
Total Medical Medicare Payment Amount |
302643.02 |
Total Medical Medicare Standardized Payment Amount |
294902.3 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
328 |
Number Of Beneficiaries Age 65 to 74 |
233 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
394 |
Number Of Non Hispanic White Beneficiaries |
330 |
Number Of Black or African American Beneficiaries |
408 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
457 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
308 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
4.2627 |