National Provider Identifier [NPI]: |
1902889942 |
Last Name Of The Provider |
AJALA |
First Name Of The Provider |
MUSA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1717 MEDICAL BLVD |
Street Address 2 Of The Provider |
STE B |
City Of The Provider |
FINDLAY |
Zip Code Of The Provider |
458401239 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1533 |
Number Of Medicare Beneficiaries |
323 |
Total Submitted Charge Amount |
480350 |
Total Medicare Allowed Amount |
269741.02 |
Total Medicare Payment Amount |
203808.15 |
Total Medicare Standardized Payment Amount |
209890.63 |
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 |
13 |
Number Of Medical Services |
1533 |
Number Of Medicare Beneficiaries With Medical Services |
323 |
Total Medical Submitted Charge Amount |
480350 |
Total Medical Medicare Allowed Amount |
269741.02 |
Total Medical Medicare Payment Amount |
203808.15 |
Total Medical Medicare Standardized Payment Amount |
209890.63 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
150 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
303 |
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 |
251 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
3.4468 |