National Provider Identifier [NPI]: |
1629206453 |
Last Name Of The Provider |
BAWA |
First Name Of The Provider |
AMIT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1800 10TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
319011513 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1015 |
Number Of Medicare Beneficiaries |
259 |
Total Submitted Charge Amount |
429672 |
Total Medicare Allowed Amount |
75718.47 |
Total Medicare Payment Amount |
59192.16 |
Total Medicare Standardized Payment Amount |
61300.47 |
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 |
13 |
Number Of Medical Services |
1015 |
Number Of Medicare Beneficiaries With Medical Services |
259 |
Total Medical Submitted Charge Amount |
429672 |
Total Medical Medicare Allowed Amount |
75718.47 |
Total Medical Medicare Payment Amount |
59192.16 |
Total Medical Medicare Standardized Payment Amount |
61300.47 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
148 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
125 |
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 |
134 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
2.7775 |