National Provider Identifier [NPI]: |
1295744811 |
Last Name Of The Provider |
KOLIA |
First Name Of The Provider |
ZARIN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5555 W. THUNDERBIRD |
Street Address 2 Of The Provider |
BANNER THUNDERBIRD MEDICAL CENTER |
City Of The Provider |
GLENDALE |
Zip Code Of The Provider |
86306 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
576 |
Number Of Medicare Beneficiaries |
317 |
Total Submitted Charge Amount |
132229 |
Total Medicare Allowed Amount |
64525.97 |
Total Medicare Payment Amount |
50075.81 |
Total Medicare Standardized Payment Amount |
50418.17 |
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 |
15 |
Number Of Medical Services |
576 |
Number Of Medicare Beneficiaries With Medical Services |
317 |
Total Medical Submitted Charge Amount |
132229 |
Total Medical Medicare Allowed Amount |
64525.97 |
Total Medical Medicare Payment Amount |
50075.81 |
Total Medical Medicare Standardized Payment Amount |
50418.17 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
142 |
Number Of Non Hispanic White Beneficiaries |
242 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
213 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.8816 |