National Provider Identifier [NPI]: |
1609829365 |
Last Name Of The Provider |
JIWANI |
First Name Of The Provider |
SHABANA |
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 |
1421 S POTOMAC ST |
Street Address 2 Of The Provider |
130 |
City Of The Provider |
AURORA |
Zip Code Of The Provider |
800124535 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
131 |
Number Of Services |
8343 |
Number Of Medicare Beneficiaries |
434 |
Total Submitted Charge Amount |
820385.19 |
Total Medicare Allowed Amount |
454298.61 |
Total Medicare Payment Amount |
338807.94 |
Total Medicare Standardized Payment Amount |
335911.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
2760 |
Number Of Medicare Beneficiaries With Drug Services |
249 |
Total Drug Submitted ChargeAmount |
117810.19 |
Total Drug Medicare AllowedAmount |
53945.14 |
Total Drug Medicare PaymentAmount |
42852.73 |
Total Drug Medicare Standardized Payment Amount |
42852.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
115 |
Number Of Medical Services |
5583 |
Number Of Medicare Beneficiaries With Medical Services |
434 |
Total Medical Submitted Charge Amount |
702575 |
Total Medical Medicare Allowed Amount |
400353.47 |
Total Medical Medicare Payment Amount |
295955.21 |
Total Medical Medicare Standardized Payment Amount |
293058.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
206 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
297 |
Number Of Male Beneficiaries |
137 |
Number Of Non Hispanic White Beneficiaries |
272 |
Number Of Black or African American Beneficiaries |
98 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
363 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.286 |