National Provider Identifier [NPI]: |
1548226541 |
Last Name Of The Provider |
ABOU-JAWDE |
First Name Of The Provider |
RONY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
902 NO RIVERSIDE RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
ST JOSEPH |
Zip Code Of The Provider |
645072559 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
112 |
Number Of Services |
29183 |
Number Of Medicare Beneficiaries |
647 |
Total Submitted Charge Amount |
1353296 |
Total Medicare Allowed Amount |
655827.92 |
Total Medicare Payment Amount |
506541.47 |
Total Medicare Standardized Payment Amount |
517609.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
53 |
Number Of Drug Services |
23994 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
883572 |
Total Drug Medicare AllowedAmount |
375161.58 |
Total Drug Medicare PaymentAmount |
293640.35 |
Total Drug Medicare Standardized Payment Amount |
293640.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
5189 |
Number Of Medicare Beneficiaries With Medical Services |
647 |
Total Medical Submitted Charge Amount |
469724 |
Total Medical Medicare Allowed Amount |
280666.34 |
Total Medical Medicare Payment Amount |
212901.12 |
Total Medical Medicare Standardized Payment Amount |
223969.63 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
284 |
Number Of Beneficiaries Age 75 to 84 |
216 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
367 |
Number Of Male Beneficiaries |
280 |
Number Of Non Hispanic White Beneficiaries |
621 |
Number Of Black or African American Beneficiaries |
14 |
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 |
564 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
83 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
51 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.8167 |