National Provider Identifier [NPI]: |
1730152216 |
Last Name Of The Provider |
SAWALHA |
First Name Of The Provider |
SAMEER |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8740 W WARREN |
Street Address 2 Of The Provider |
|
City Of The Provider |
DEARBORN |
Zip Code Of The Provider |
48126 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
8186 |
Number Of Medicare Beneficiaries |
472 |
Total Submitted Charge Amount |
533825 |
Total Medicare Allowed Amount |
410678.25 |
Total Medicare Payment Amount |
299758.27 |
Total Medicare Standardized Payment Amount |
291852.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
3121 |
Number Of Medicare Beneficiaries With Drug Services |
174 |
Total Drug Submitted ChargeAmount |
9910 |
Total Drug Medicare AllowedAmount |
2410.11 |
Total Drug Medicare PaymentAmount |
2245.8 |
Total Drug Medicare Standardized Payment Amount |
2245.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
5065 |
Number Of Medicare Beneficiaries With Medical Services |
472 |
Total Medical Submitted Charge Amount |
523915 |
Total Medical Medicare Allowed Amount |
408268.14 |
Total Medical Medicare Payment Amount |
297512.47 |
Total Medical Medicare Standardized Payment Amount |
289606.84 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
247 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
262 |
Number Of Non Hispanic White Beneficiaries |
146 |
Number Of Black or African American Beneficiaries |
254 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
37 |
Number Of Beneficiaries With Medicare Only Entitlement |
114 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
358 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5738 |