| National Provider Identifier [NPI]: | 1629238951 |
| Last Name Of The Provider | JARAVAZA |
| First Name Of The Provider | TINEVIMBO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 277 E MOUNTAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WORCESTER |
| Zip Code Of The Provider | 016061207 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1280 |
| Number Of Medicare Beneficiaries | 420 |
| Total Submitted Charge Amount | 406299 |
| Total Medicare Allowed Amount | 124647.85 |
| Total Medicare Payment Amount | 89815.5 |
| Total Medicare Standardized Payment Amount | 84284.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 81 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 3880 |
| Total Drug Medicare AllowedAmount | 2851.87 |
| Total Drug Medicare PaymentAmount | 2791.59 |
| Total Drug Medicare Standardized Payment Amount | 2791.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1199 |
| Number Of Medicare Beneficiaries With Medical Services | 420 |
| Total Medical Submitted Charge Amount | 402419 |
| Total Medical Medicare Allowed Amount | 121795.98 |
| Total Medical Medicare Payment Amount | 87023.91 |
| Total Medical Medicare Standardized Payment Amount | 81492.42 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 173 |
| Number Of Beneficiaries Age Greater 84 | 161 |
| Number Of Female Beneficiaries | 299 |
| Number Of Male Beneficiaries | 121 |
| Number Of Non Hispanic White Beneficiaries | 380 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| 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 | 356 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 29 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5731 |