National Provider Identifier [NPI]: |
1801886593 |
Last Name Of The Provider |
KAYALI |
First Name Of The Provider |
MUHANNAD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6920 OGDEN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BERWYN |
Zip Code Of The Provider |
604023685 |
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 |
51 |
Number Of Services |
1068 |
Number Of Medicare Beneficiaries |
72 |
Total Submitted Charge Amount |
86678 |
Total Medicare Allowed Amount |
45774.48 |
Total Medicare Payment Amount |
35128.9 |
Total Medicare Standardized Payment Amount |
33029.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
111 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
6265 |
Total Drug Medicare AllowedAmount |
234.81 |
Total Drug Medicare PaymentAmount |
215.6 |
Total Drug Medicare Standardized Payment Amount |
215.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
957 |
Number Of Medicare Beneficiaries With Medical Services |
72 |
Total Medical Submitted Charge Amount |
80413 |
Total Medical Medicare Allowed Amount |
45539.67 |
Total Medical Medicare Payment Amount |
34913.3 |
Total Medical Medicare Standardized Payment Amount |
32813.42 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
14 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
40 |
Number Of Male Beneficiaries |
32 |
Number Of Non Hispanic White Beneficiaries |
47 |
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 |
32 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
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 |
1.5338 |