National Provider Identifier [NPI]: |
1770686669 |
Last Name Of The Provider |
TINAWI |
First Name Of The Provider |
MOHAMMAD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
801 MACARTHUR BLVD |
Street Address 2 Of The Provider |
SUITE 400 A |
City Of The Provider |
MUNSTER |
Zip Code Of The Provider |
463212915 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
2889 |
Number Of Medicare Beneficiaries |
502 |
Total Submitted Charge Amount |
543725 |
Total Medicare Allowed Amount |
260907.28 |
Total Medicare Payment Amount |
202040.87 |
Total Medicare Standardized Payment Amount |
210855.45 |
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 |
24 |
Number Of Medical Services |
2889 |
Number Of Medicare Beneficiaries With Medical Services |
502 |
Total Medical Submitted Charge Amount |
543725 |
Total Medical Medicare Allowed Amount |
260907.28 |
Total Medical Medicare Payment Amount |
202040.87 |
Total Medical Medicare Standardized Payment Amount |
210855.45 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
112 |
Number Of Female Beneficiaries |
276 |
Number Of Male Beneficiaries |
226 |
Number Of Non Hispanic White Beneficiaries |
273 |
Number Of Black or African American Beneficiaries |
151 |
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 |
327 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
175 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
73 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
69 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
3.9206 |