National Provider Identifier [NPI]: |
1306096938 |
Last Name Of The Provider |
JEELANI |
First Name Of The Provider |
OWAIS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.B.B.S |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
142 S MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DANVILLE |
Zip Code Of The Provider |
245412922 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1994 |
Number Of Medicare Beneficiaries |
636 |
Total Submitted Charge Amount |
210773.38 |
Total Medicare Allowed Amount |
208920.83 |
Total Medicare Payment Amount |
160178.79 |
Total Medicare Standardized Payment Amount |
163289.9 |
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 |
14 |
Number Of Medical Services |
1994 |
Number Of Medicare Beneficiaries With Medical Services |
636 |
Total Medical Submitted Charge Amount |
210773.38 |
Total Medical Medicare Allowed Amount |
208920.83 |
Total Medical Medicare Payment Amount |
160178.79 |
Total Medical Medicare Standardized Payment Amount |
163289.9 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
184 |
Number Of Beneficiaries Age 75 to 84 |
186 |
Number Of Beneficiaries Age Greater 84 |
153 |
Number Of Female Beneficiaries |
364 |
Number Of Male Beneficiaries |
272 |
Number Of Non Hispanic White Beneficiaries |
418 |
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 |
343 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
293 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.4203 |