National Provider Identifier [NPI]: |
1942424528 |
Last Name Of The Provider |
AWAN |
First Name Of The Provider |
FARRUKH |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D., M.S. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 W 10TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432101280 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
380 |
Number Of Medicare Beneficiaries |
77 |
Total Submitted Charge Amount |
91405 |
Total Medicare Allowed Amount |
42009.68 |
Total Medicare Payment Amount |
32253.92 |
Total Medicare Standardized Payment Amount |
32955.73 |
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 |
12 |
Number Of Medical Services |
380 |
Number Of Medicare Beneficiaries With Medical Services |
77 |
Total Medical Submitted Charge Amount |
91405 |
Total Medical Medicare Allowed Amount |
42009.68 |
Total Medical Medicare Payment Amount |
32253.92 |
Total Medical Medicare Standardized Payment Amount |
32955.73 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
24 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
64 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.2735 |