National Provider Identifier [NPI]: |
1124284815 |
Last Name Of The Provider |
PERVAIZ |
First Name Of The Provider |
GHAZIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 MICHIGAN ST NE |
Street Address 2 Of The Provider |
STE A721 |
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495032560 |
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 |
12 |
Number Of Services |
859 |
Number Of Medicare Beneficiaries |
275 |
Total Submitted Charge Amount |
116960 |
Total Medicare Allowed Amount |
66548.08 |
Total Medicare Payment Amount |
52166.11 |
Total Medicare Standardized Payment Amount |
53321.73 |
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 |
859 |
Number Of Medicare Beneficiaries With Medical Services |
275 |
Total Medical Submitted Charge Amount |
116960 |
Total Medical Medicare Allowed Amount |
66548.08 |
Total Medical Medicare Payment Amount |
52166.11 |
Total Medical Medicare Standardized Payment Amount |
53321.73 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
233 |
Number Of Black or African American Beneficiaries |
27 |
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 |
167 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.5518 |