National Provider Identifier [NPI]: |
1851386460 |
Last Name Of The Provider |
BURHANI |
First Name Of The Provider |
NAFISA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2614 W JEFFERSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JOLIET |
Zip Code Of The Provider |
60435 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
2544 |
Number Of Medicare Beneficiaries |
717 |
Total Submitted Charge Amount |
626206 |
Total Medicare Allowed Amount |
286023.67 |
Total Medicare Payment Amount |
212614.42 |
Total Medicare Standardized Payment Amount |
208150.64 |
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 |
18 |
Number Of Medical Services |
2544 |
Number Of Medicare Beneficiaries With Medical Services |
717 |
Total Medical Submitted Charge Amount |
626206 |
Total Medical Medicare Allowed Amount |
286023.67 |
Total Medical Medicare Payment Amount |
212614.42 |
Total Medical Medicare Standardized Payment Amount |
208150.64 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
309 |
Number Of Beneficiaries Age 75 to 84 |
222 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
497 |
Number Of Male Beneficiaries |
220 |
Number Of Non Hispanic White Beneficiaries |
641 |
Number Of Black or African American Beneficiaries |
42 |
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 |
601 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
116 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
47 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.019 |