National Provider Identifier [NPI]: |
1205945862 |
Last Name Of The Provider |
LOMAN |
First Name Of The Provider |
JAMIL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20045 N 19TH AVE |
Street Address 2 Of The Provider |
BUILDING 8 STE 265 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850274252 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
1204 |
Number Of Medicare Beneficiaries |
80 |
Total Submitted Charge Amount |
57308.61 |
Total Medicare Allowed Amount |
34292.66 |
Total Medicare Payment Amount |
26133.44 |
Total Medicare Standardized Payment Amount |
18700.4 |
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 |
10 |
Number Of Medical Services |
1204 |
Number Of Medicare Beneficiaries With Medical Services |
80 |
Total Medical Submitted Charge Amount |
57308.61 |
Total Medical Medicare Allowed Amount |
34292.66 |
Total Medical Medicare Payment Amount |
26133.44 |
Total Medical Medicare Standardized Payment Amount |
18700.4 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
52 |
Number Of Male Beneficiaries |
28 |
Number Of Non Hispanic White Beneficiaries |
68 |
Number Of Black or African American Beneficiaries |
|
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
62 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1648 |