Sulieman Abdal raheem MD

Gender: M
Medical School: Other
Graduation Year: 2002
Primary Specialty: Gastroenterology

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted44
Total Provider Services625
Total Medicare beneficiaries receiving the provider services287
The total charges that the provider submitted for all services$320,626.00
The Medicare allowed amount for all provider services. This figure is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying.$55,578.61
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$42,447.34
Total Medicare Standardized Payment Amount$44,044.27
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File0
Total drug services, as defined from the Medicare Part B Drug ASP File0
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.0
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$0.00
The Medicare allowed amount for drug services, as defined from the Medicare Part B Drug ASP File. This figure is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying.$0.00
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item drug services, as defined from the Medicare Part B Drug ASP File.$0.00
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for the line item drug service , as defined from the Medicare Part B Drug ASP File and after standardization of the Medicare payment has been applied. Standardization removes geographic differences in payment rates for individual services, such as those that account for local wages or input prices and makes Medicare payments across geographic areas comparable, so that differences reflect variation in factors such as physicians’ practice patterns and beneficiaries’ ability and willingness to obtain care.$0.00
Total number of HCPCS codes associated with medical (non-ASP) services44
Total medical (non-ASP) services625
Total Medicare beneficiaries receiving medical (non-ASP) services287
The total charges that the provider submitted for medical services (non-ASP)$320,626.00
The Medicare allowed amount for medical (non-ASP) services. This figure is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying.$55,578.61
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$42,447.34
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for the line item medical (non-ASP) service , as defined from the Medicare Part B Drug ASP File and after standardization of the Medicare payment has been applied. Standardization removes geographic differences in payment rates for individual services, such as those that account for local wages or input prices and makes Medicare payments across geographic areas comparable, so that differences reflect variation in factors such as physicians’ practice patterns and beneficiaries’ ability and willingness to obtain care$44,044.27
Average age of beneficiaries68
Number of beneficiaries under the age of 6580
Number of beneficiaries between the ages of 65 and 74129
Number of beneficiaries between the ages of 75 and 8463
Number of beneficiaries over the age of 8415
Number of Female beneficiaries147
Number of Male Beneficiaries140
Number of Non-Hispanic White Beneficiaries230
Number of Black or African American Beneficiaries40
Number of Asian Pacific Islander Beneficiaries0
Number of Medicare beneficiaries qualified to receive Medicare only benefits. Beneficiaries are classified as Medicare only entitlement if they received zero months of any Medicaid benefits (full or partial) in the given calendar year219
Number of Medicare beneficiaries qualified to receive Medicare and Medicaid benefits. Beneficiaries are classified as Medicare and Medicaid entitlement if in any month in the given calendar year they were receiving full or partial Medicaid benefits68
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation16%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia11%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma11%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer15%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure24%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease50%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease19%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression40%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes42%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia52%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension72%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease37%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis9%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis46%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke5%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries2.2455

Source: data.cms.gov

Sulieman Abdal raheem MD's 2017 Charges to Medicare:

Services Description Times Provided Beneficiaries Beneficiaries per day Medicare Avg. Amt. Average Charge Avg Medicare Payment Percentage of Average
Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope 14 14 14 $98.95 $712.71 $77.58 919%
Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope 42 41 42 $108.55 $824.6 $82.44 1000%
Biopsy of large bowel using an endoscope 30 30 30 $142.85 $1304.6 $112.0 1165%
Removal of polyps or growths of large bowel using an endoscope 25 25 25 $243.59 $1486.32 $185.23 802%
New patient office or other outpatient visit, typically 30 minutes 17 17 17 $76.11 $318.47 $47.07 677%
New patient office or other outpatient visit, typically 30 minutes 12 12 12 $85.77 $280.67 $62.27 451%
New patient office or other outpatient visit, typically 45 minutes 22 22 22 $128.7 $516.23 $100.9 512%
New patient office or other outpatient visit, typically 45 minutes 13 13 13 $148.16 $404.62 $108.39 373%
Established patient office or other outpatient visit, typically 15 minutes 36 27 36 $50.5 $219.0 $39.59 553%
Established patient office or other outpatient visit, typically 15 minutes 18 14 18 $58.45 $186.39 $45.82 407%
Established patient office or other outpatient, visit typically 25 minutes 30 26 30 $77.84 $325.3 $53.01 614%
Established patient office or other outpatient, visit typically 25 minutes 12 11 12 $93.41 $259.08 $68.14 380%
Initial hospital inpatient care, typically 30 minutes per day 15 15 15 $100.76 $401.07 $79.0 508%
Initial hospital inpatient care, typically 50 minutes per day 29 29 29 $135.79 $471.03 $106.46 442%
Subsequent hospital inpatient care, typically 25 minutes per day 91 37 91 $71.56 $329.76 $56.1 588%
Subsequent hospital inpatient care, typically 35 minutes per day 18 12 18 $103.48 $475.44 $76.61 621%
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito 85 79 85 $5.62 $243.0 $4.32 5627%
Source: 2017 Provider CMS Charge Data