National Provider Identifier [NPI]: |
1255387494 |
Last Name Of The Provider |
AL-JOUNDI |
First Name Of The Provider |
TAMMAM |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10012 KENNERLY ROAD |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
ST LOUIS |
Zip Code Of The Provider |
63128 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
110 |
Number Of Services |
12826 |
Number Of Medicare Beneficiaries |
1985 |
Total Submitted Charge Amount |
1633702.6 |
Total Medicare Allowed Amount |
574914.69 |
Total Medicare Payment Amount |
432657.67 |
Total Medicare Standardized Payment Amount |
441227.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
6876 |
Number Of Medicare Beneficiaries With Drug Services |
111 |
Total Drug Submitted ChargeAmount |
43890.84 |
Total Drug Medicare AllowedAmount |
10911.9 |
Total Drug Medicare PaymentAmount |
8554.84 |
Total Drug Medicare Standardized Payment Amount |
8554.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
103 |
Number Of Medical Services |
5950 |
Number Of Medicare Beneficiaries With Medical Services |
1985 |
Total Medical Submitted Charge Amount |
1589811.76 |
Total Medical Medicare Allowed Amount |
564002.79 |
Total Medical Medicare Payment Amount |
424102.83 |
Total Medical Medicare Standardized Payment Amount |
432672.36 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
349 |
Number Of Beneficiaries Age 65 to 74 |
622 |
Number Of Beneficiaries Age 75 to 84 |
601 |
Number Of Beneficiaries Age Greater 84 |
413 |
Number Of Female Beneficiaries |
1042 |
Number Of Male Beneficiaries |
943 |
Number Of Non Hispanic White Beneficiaries |
1915 |
Number Of Black or African American Beneficiaries |
37 |
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 |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
1484 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
501 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7952 |