National Provider Identifier [NPI]: |
1407851488 |
Last Name Of The Provider |
HARB |
First Name Of The Provider |
TAREQ |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4403 HARRISON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
OGDEN |
Zip Code Of The Provider |
844033271 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
117 |
Number Of Services |
4087 |
Number Of Medicare Beneficiaries |
1350 |
Total Submitted Charge Amount |
1564109.86 |
Total Medicare Allowed Amount |
393093.67 |
Total Medicare Payment Amount |
294505.77 |
Total Medicare Standardized Payment Amount |
303199.59 |
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 |
117 |
Number Of Medical Services |
4087 |
Number Of Medicare Beneficiaries With Medical Services |
1350 |
Total Medical Submitted Charge Amount |
1564109.86 |
Total Medical Medicare Allowed Amount |
393093.67 |
Total Medical Medicare Payment Amount |
294505.77 |
Total Medical Medicare Standardized Payment Amount |
303199.59 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
155 |
Number Of Beneficiaries Age 65 to 74 |
485 |
Number Of Beneficiaries Age 75 to 84 |
504 |
Number Of Beneficiaries Age Greater 84 |
206 |
Number Of Female Beneficiaries |
647 |
Number Of Male Beneficiaries |
703 |
Number Of Non Hispanic White Beneficiaries |
1212 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
84 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
1176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4418 |