National Provider Identifier [NPI]: |
1720379142 |
Last Name Of The Provider |
NAWAZ |
First Name Of The Provider |
AMJID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3535 SOUTHERN BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
KETTERING |
Zip Code Of The Provider |
454291221 |
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 |
15 |
Number Of Services |
263 |
Number Of Medicare Beneficiaries |
107 |
Total Submitted Charge Amount |
68874 |
Total Medicare Allowed Amount |
27855.77 |
Total Medicare Payment Amount |
21756.22 |
Total Medicare Standardized Payment Amount |
22120.32 |
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 |
15 |
Number Of Medical Services |
263 |
Number Of Medicare Beneficiaries With Medical Services |
107 |
Total Medical Submitted Charge Amount |
68874 |
Total Medical Medicare Allowed Amount |
27855.77 |
Total Medical Medicare Payment Amount |
21756.22 |
Total Medical Medicare Standardized Payment Amount |
22120.32 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
34 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
52 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
62 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
24 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
28 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1726 |