National Provider Identifier [NPI]: |
1245206903 |
Last Name Of The Provider |
EL-GAZZAR |
First Name Of The Provider |
MOURAD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15000 MADISON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKEWOOD |
Zip Code Of The Provider |
44107 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
4756 |
Number Of Medicare Beneficiaries |
1224 |
Total Submitted Charge Amount |
427252.2 |
Total Medicare Allowed Amount |
255984.28 |
Total Medicare Payment Amount |
193413.67 |
Total Medicare Standardized Payment Amount |
196010.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
30 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
1022.95 |
Total Drug Medicare AllowedAmount |
652.46 |
Total Drug Medicare PaymentAmount |
637.23 |
Total Drug Medicare Standardized Payment Amount |
637.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
4726 |
Number Of Medicare Beneficiaries With Medical Services |
1224 |
Total Medical Submitted Charge Amount |
426229.25 |
Total Medical Medicare Allowed Amount |
255331.82 |
Total Medical Medicare Payment Amount |
192776.44 |
Total Medical Medicare Standardized Payment Amount |
195373.71 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
384 |
Number Of Beneficiaries Age 65 to 74 |
332 |
Number Of Beneficiaries Age 75 to 84 |
264 |
Number Of Beneficiaries Age Greater 84 |
244 |
Number Of Female Beneficiaries |
700 |
Number Of Male Beneficiaries |
524 |
Number Of Non Hispanic White Beneficiaries |
1005 |
Number Of Black or African American Beneficiaries |
133 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
632 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
592 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.234 |