National Provider Identifier [NPI]: |
1558370411 |
Last Name Of The Provider |
ABDULFATTAH |
First Name Of The Provider |
QAHTAN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11323 CORTEZ BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROOKSVILLE |
Zip Code Of The Provider |
346135407 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
9648 |
Number Of Medicare Beneficiaries |
911 |
Total Submitted Charge Amount |
952807 |
Total Medicare Allowed Amount |
341715.62 |
Total Medicare Payment Amount |
262978.59 |
Total Medicare Standardized Payment Amount |
262078.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
7200 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
56001 |
Total Drug Medicare AllowedAmount |
38599 |
Total Drug Medicare PaymentAmount |
30261.67 |
Total Drug Medicare Standardized Payment Amount |
30261.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
2448 |
Number Of Medicare Beneficiaries With Medical Services |
911 |
Total Medical Submitted Charge Amount |
896806 |
Total Medical Medicare Allowed Amount |
303116.62 |
Total Medical Medicare Payment Amount |
232716.92 |
Total Medical Medicare Standardized Payment Amount |
231817.11 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
180 |
Number Of Beneficiaries Age 65 to 74 |
279 |
Number Of Beneficiaries Age 75 to 84 |
297 |
Number Of Beneficiaries Age Greater 84 |
155 |
Number Of Female Beneficiaries |
517 |
Number Of Male Beneficiaries |
394 |
Number Of Non Hispanic White Beneficiaries |
792 |
Number Of Black or African American Beneficiaries |
47 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
57 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
699 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
212 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
1.7726 |