National Provider Identifier [NPI]: |
1295925840 |
Last Name Of The Provider |
KHAYAL |
First Name Of The Provider |
SABA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
880 MADISON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381033409 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
4395 |
Number Of Medicare Beneficiaries |
322 |
Total Submitted Charge Amount |
114687.9 |
Total Medicare Allowed Amount |
43403.1 |
Total Medicare Payment Amount |
25914.16 |
Total Medicare Standardized Payment Amount |
28966.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
3390 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
711.9 |
Total Drug Medicare AllowedAmount |
586.47 |
Total Drug Medicare PaymentAmount |
459.91 |
Total Drug Medicare Standardized Payment Amount |
459.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
1005 |
Number Of Medicare Beneficiaries With Medical Services |
322 |
Total Medical Submitted Charge Amount |
113976 |
Total Medical Medicare Allowed Amount |
42816.63 |
Total Medical Medicare Payment Amount |
25454.25 |
Total Medical Medicare Standardized Payment Amount |
28506.81 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
269 |
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 |
187 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6901 |