National Provider Identifier [NPI]: |
1104032028 |
Last Name Of The Provider |
NADIR |
First Name Of The Provider |
EHREEMA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2531 S GILBERT RD |
Street Address 2 Of The Provider |
STE 111 |
City Of The Provider |
GILBERT |
Zip Code Of The Provider |
852955874 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
3717 |
Number Of Medicare Beneficiaries |
979 |
Total Submitted Charge Amount |
417228.2 |
Total Medicare Allowed Amount |
351857.13 |
Total Medicare Payment Amount |
255137.13 |
Total Medicare Standardized Payment Amount |
261428.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
572 |
Number Of Medicare Beneficiaries With Drug Services |
74 |
Total Drug Submitted ChargeAmount |
3023.2 |
Total Drug Medicare AllowedAmount |
442.14 |
Total Drug Medicare PaymentAmount |
335.89 |
Total Drug Medicare Standardized Payment Amount |
335.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
3145 |
Number Of Medicare Beneficiaries With Medical Services |
979 |
Total Medical Submitted Charge Amount |
414205 |
Total Medical Medicare Allowed Amount |
351414.99 |
Total Medical Medicare Payment Amount |
254801.24 |
Total Medical Medicare Standardized Payment Amount |
261092.48 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
213 |
Number Of Beneficiaries Age 65 to 74 |
388 |
Number Of Beneficiaries Age 75 to 84 |
237 |
Number Of Beneficiaries Age Greater 84 |
141 |
Number Of Female Beneficiaries |
579 |
Number Of Male Beneficiaries |
400 |
Number Of Non Hispanic White Beneficiaries |
765 |
Number Of Black or African American Beneficiaries |
51 |
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
99 |
Number Of American Indian Alaska Native Beneficiaries |
30 |
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
741 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
238 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9201 |