| National Provider Identifier [NPI]: | 1760658330 |
| Last Name Of The Provider | MOITHEENNAZIMA |
| First Name Of The Provider | BINUSHA |
| 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 | 1209 N MOUND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NACOGDOCHES |
| Zip Code Of The Provider | 759614028 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 9580 |
| Number Of Medicare Beneficiaries | 763 |
| Total Submitted Charge Amount | 1850438.27 |
| Total Medicare Allowed Amount | 697990.5 |
| Total Medicare Payment Amount | 532240.34 |
| Total Medicare Standardized Payment Amount | 562318.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 529 |
| Number Of Medicare Beneficiaries With Drug Services | 213 |
| Total Drug Submitted ChargeAmount | 36252.4 |
| Total Drug Medicare AllowedAmount | 4285.16 |
| Total Drug Medicare PaymentAmount | 4028.7 |
| Total Drug Medicare Standardized Payment Amount | 4028.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 9051 |
| Number Of Medicare Beneficiaries With Medical Services | 763 |
| Total Medical Submitted Charge Amount | 1814185.87 |
| Total Medical Medicare Allowed Amount | 693705.34 |
| Total Medical Medicare Payment Amount | 528211.64 |
| Total Medical Medicare Standardized Payment Amount | 558290.27 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 190 |
| Number Of Beneficiaries Age 65 to 74 | 289 |
| Number Of Beneficiaries Age 75 to 84 | 196 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 430 |
| Number Of Male Beneficiaries | 333 |
| Number Of Non Hispanic White Beneficiaries | 573 |
| Number Of Black or African American Beneficiaries | 162 |
| 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 | 454 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 309 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 69 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.145 |