National Provider Identifier [NPI]: |
1710938246 |
Last Name Of The Provider |
LATEEF |
First Name Of The Provider |
MUJAHED |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3824 NORTHERN PIKE |
Street Address 2 Of The Provider |
STE 960 |
City Of The Provider |
MONROEVILLE |
Zip Code Of The Provider |
151462141 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
651 |
Number Of Medicare Beneficiaries |
68 |
Total Submitted Charge Amount |
75102 |
Total Medicare Allowed Amount |
38565.39 |
Total Medicare Payment Amount |
29017.12 |
Total Medicare Standardized Payment Amount |
29937.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
234 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
1797 |
Total Drug Medicare AllowedAmount |
502.73 |
Total Drug Medicare PaymentAmount |
386.94 |
Total Drug Medicare Standardized Payment Amount |
386.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
417 |
Number Of Medicare Beneficiaries With Medical Services |
68 |
Total Medical Submitted Charge Amount |
73305 |
Total Medical Medicare Allowed Amount |
38062.66 |
Total Medical Medicare Payment Amount |
28630.18 |
Total Medical Medicare Standardized Payment Amount |
29550.34 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
19 |
Number Of Beneficiaries Age 75 to 84 |
13 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
29 |
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 |
46 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
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 |
24 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5522 |