National Provider Identifier [NPI]: |
1528111341 |
Last Name Of The Provider |
LODHI |
First Name Of The Provider |
FAUZIA |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6374 N LINCOLN AVE |
Street Address 2 Of The Provider |
SUITE 303 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606591275 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
2530 |
Number Of Medicare Beneficiaries |
326 |
Total Submitted Charge Amount |
145140 |
Total Medicare Allowed Amount |
114331.14 |
Total Medicare Payment Amount |
79945.47 |
Total Medicare Standardized Payment Amount |
76097.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
329 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
8635 |
Total Drug Medicare AllowedAmount |
4412.98 |
Total Drug Medicare PaymentAmount |
3356.93 |
Total Drug Medicare Standardized Payment Amount |
3356.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
2201 |
Number Of Medicare Beneficiaries With Medical Services |
326 |
Total Medical Submitted Charge Amount |
136505 |
Total Medical Medicare Allowed Amount |
109918.16 |
Total Medical Medicare Payment Amount |
76588.54 |
Total Medical Medicare Standardized Payment Amount |
72740.56 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
189 |
Number Of Male Beneficiaries |
137 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
17 |
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 |
299 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3002 |