National Provider Identifier [NPI]: |
1396784914 |
Last Name Of The Provider |
HAQUE |
First Name Of The Provider |
SEEMA |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
902 W RANDOL MILL RD |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
760122572 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
1390 |
Number Of Medicare Beneficiaries |
369 |
Total Submitted Charge Amount |
231900 |
Total Medicare Allowed Amount |
117888.97 |
Total Medicare Payment Amount |
87559.06 |
Total Medicare Standardized Payment Amount |
91390.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
1390 |
Number Of Medicare Beneficiaries With Medical Services |
369 |
Total Medical Submitted Charge Amount |
231900 |
Total Medical Medicare Allowed Amount |
117888.97 |
Total Medical Medicare Payment Amount |
87559.06 |
Total Medical Medicare Standardized Payment Amount |
91390.71 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
205 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
235 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
281 |
Number Of Black or African American Beneficiaries |
52 |
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 |
242 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
28 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5666 |