| National Provider Identifier [NPI]: | 1912015769 |
| Last Name Of The Provider | DALWAI |
| First Name Of The Provider | FATIMA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 HIGHWAY 34 E |
| Street Address 2 Of The Provider | BLDG 300 |
| City Of The Provider | NEWNAN |
| Zip Code Of The Provider | 302652315 |
| 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 | 55 |
| Number Of Services | 1917 |
| Number Of Medicare Beneficiaries | 397 |
| Total Submitted Charge Amount | 198286.6 |
| Total Medicare Allowed Amount | 80151.05 |
| Total Medicare Payment Amount | 56336.19 |
| Total Medicare Standardized Payment Amount | 60698.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 190 |
| Number Of Medicare Beneficiaries With Drug Services | 111 |
| Total Drug Submitted ChargeAmount | 16395 |
| Total Drug Medicare AllowedAmount | 5192.19 |
| Total Drug Medicare PaymentAmount | 5025.47 |
| Total Drug Medicare Standardized Payment Amount | 5025.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1727 |
| Number Of Medicare Beneficiaries With Medical Services | 397 |
| Total Medical Submitted Charge Amount | 181891.6 |
| Total Medical Medicare Allowed Amount | 74958.86 |
| Total Medical Medicare Payment Amount | 51310.72 |
| Total Medical Medicare Standardized Payment Amount | 55673.18 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 296 |
| Number Of Male Beneficiaries | 101 |
| Number Of Non Hispanic White Beneficiaries | 326 |
| Number Of Black or African American Beneficiaries | 54 |
| 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 | 301 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0229 |