National Provider Identifier [NPI]: |
1982869293 |
Last Name Of The Provider |
ILYAS |
First Name Of The Provider |
MAHWISH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
67 MASONIC AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WALLINGFORD |
Zip Code Of The Provider |
064923095 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
974 |
Number Of Medicare Beneficiaries |
289 |
Total Submitted Charge Amount |
170555 |
Total Medicare Allowed Amount |
88441.82 |
Total Medicare Payment Amount |
67914.2 |
Total Medicare Standardized Payment Amount |
61097.78 |
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 |
16 |
Number Of Medical Services |
974 |
Number Of Medicare Beneficiaries With Medical Services |
289 |
Total Medical Submitted Charge Amount |
170555 |
Total Medical Medicare Allowed Amount |
88441.82 |
Total Medical Medicare Payment Amount |
67914.2 |
Total Medical Medicare Standardized Payment Amount |
61097.78 |
Average Age Of Beneficiaries |
82 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
143 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
276 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
183 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
50 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
57 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
26 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.2006 |