National Provider Identifier [NPI]: |
1386610285 |
Last Name Of The Provider |
ABDALLA |
First Name Of The Provider |
ISMAILE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1901 PORT LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
AMARILLO |
Zip Code Of The Provider |
791062430 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Electrophysiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
125 |
Number Of Services |
13813 |
Number Of Medicare Beneficiaries |
2194 |
Total Submitted Charge Amount |
2845934.6 |
Total Medicare Allowed Amount |
752001.33 |
Total Medicare Payment Amount |
559330.68 |
Total Medicare Standardized Payment Amount |
585528.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
4295 |
Number Of Medicare Beneficiaries With Drug Services |
130 |
Total Drug Submitted ChargeAmount |
51845 |
Total Drug Medicare AllowedAmount |
23890.16 |
Total Drug Medicare PaymentAmount |
18537.86 |
Total Drug Medicare Standardized Payment Amount |
18537.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
120 |
Number Of Medical Services |
9518 |
Number Of Medicare Beneficiaries With Medical Services |
2194 |
Total Medical Submitted Charge Amount |
2794089.6 |
Total Medical Medicare Allowed Amount |
728111.17 |
Total Medical Medicare Payment Amount |
540792.82 |
Total Medical Medicare Standardized Payment Amount |
566990.75 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
259 |
Number Of Beneficiaries Age 65 to 74 |
704 |
Number Of Beneficiaries Age 75 to 84 |
819 |
Number Of Beneficiaries Age Greater 84 |
412 |
Number Of Female Beneficiaries |
1184 |
Number Of Male Beneficiaries |
1010 |
Number Of Non Hispanic White Beneficiaries |
1840 |
Number Of Black or African American Beneficiaries |
80 |
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
239 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1764 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
430 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7236 |