National Provider Identifier [NPI]: |
1063678878 |
Last Name Of The Provider |
NWADIARO |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
303 S NAPPANEE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ELKHART |
Zip Code Of The Provider |
465142066 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1313 |
Number Of Medicare Beneficiaries |
428 |
Total Submitted Charge Amount |
253972.54 |
Total Medicare Allowed Amount |
106291.57 |
Total Medicare Payment Amount |
83026.41 |
Total Medicare Standardized Payment Amount |
87675.48 |
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 |
20 |
Number Of Medical Services |
1313 |
Number Of Medicare Beneficiaries With Medical Services |
428 |
Total Medical Submitted Charge Amount |
253972.54 |
Total Medical Medicare Allowed Amount |
106291.57 |
Total Medical Medicare Payment Amount |
83026.41 |
Total Medical Medicare Standardized Payment Amount |
87675.48 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
189 |
Number Of Non Hispanic White Beneficiaries |
231 |
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 |
309 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.739 |