National Provider Identifier [NPI]: |
1649577560 |
Last Name Of The Provider |
DEWANJEE |
First Name Of The Provider |
JESSIE |
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 |
720 TUCKAHOE RD |
Street Address 2 Of The Provider |
APT-2D |
City Of The Provider |
YONKERS |
Zip Code Of The Provider |
107105259 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1495 |
Number Of Medicare Beneficiaries |
559 |
Total Submitted Charge Amount |
309748 |
Total Medicare Allowed Amount |
159073.79 |
Total Medicare Payment Amount |
123044.34 |
Total Medicare Standardized Payment Amount |
117443.24 |
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 |
19 |
Number Of Medical Services |
1495 |
Number Of Medicare Beneficiaries With Medical Services |
559 |
Total Medical Submitted Charge Amount |
309748 |
Total Medical Medicare Allowed Amount |
159073.79 |
Total Medical Medicare Payment Amount |
123044.34 |
Total Medical Medicare Standardized Payment Amount |
117443.24 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
187 |
Number Of Beneficiaries Age Greater 84 |
188 |
Number Of Female Beneficiaries |
312 |
Number Of Male Beneficiaries |
247 |
Number Of Non Hispanic White Beneficiaries |
413 |
Number Of Black or African American Beneficiaries |
97 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
314 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
245 |
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.6624 |