National Provider Identifier [NPI]: |
1568445666 |
Last Name Of The Provider |
ANDRAWIS |
First Name Of The Provider |
ASHRAF |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1543 KINGSLEY AVE |
Street Address 2 Of The Provider |
BLDG 3 |
City Of The Provider |
ORANGE PARK |
Zip Code Of The Provider |
320734535 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
13778 |
Number Of Medicare Beneficiaries |
968 |
Total Submitted Charge Amount |
2797317.4 |
Total Medicare Allowed Amount |
715252.33 |
Total Medicare Payment Amount |
515280.58 |
Total Medicare Standardized Payment Amount |
540473.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
6491 |
Number Of Medicare Beneficiaries With Drug Services |
374 |
Total Drug Submitted ChargeAmount |
379316.28 |
Total Drug Medicare AllowedAmount |
18936.2 |
Total Drug Medicare PaymentAmount |
14777.23 |
Total Drug Medicare Standardized Payment Amount |
14777.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
7287 |
Number Of Medicare Beneficiaries With Medical Services |
968 |
Total Medical Submitted Charge Amount |
2418001.12 |
Total Medical Medicare Allowed Amount |
696316.13 |
Total Medical Medicare Payment Amount |
500503.35 |
Total Medical Medicare Standardized Payment Amount |
525696.05 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
373 |
Number Of Beneficiaries Age 65 to 74 |
316 |
Number Of Beneficiaries Age 75 to 84 |
213 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
637 |
Number Of Male Beneficiaries |
331 |
Number Of Non Hispanic White Beneficiaries |
794 |
Number Of Black or African American Beneficiaries |
123 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
695 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
273 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4428 |