National Provider Identifier [NPI]: |
1912126913 |
Last Name Of The Provider |
KASEB |
First Name Of The Provider |
ENAS |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4755 ALDINE MAIL ROUTE |
Street Address 2 Of The Provider |
DEPARTMENT OF FAMILY MEDICINE |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770395934 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
15735 |
Number Of Medicare Beneficiaries |
63 |
Total Submitted Charge Amount |
789479.5 |
Total Medicare Allowed Amount |
739154.42 |
Total Medicare Payment Amount |
577290.08 |
Total Medicare Standardized Payment Amount |
636993.51 |
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 |
9 |
Number Of Medical Services |
15735 |
Number Of Medicare Beneficiaries With Medical Services |
63 |
Total Medical Submitted Charge Amount |
789479.5 |
Total Medical Medicare Allowed Amount |
739154.42 |
Total Medical Medicare Payment Amount |
577290.08 |
Total Medical Medicare Standardized Payment Amount |
636993.51 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
27 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
19 |
Number Of Black or African American Beneficiaries |
32 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
26 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
70 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
71 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.9397 |