| National Provider Identifier [NPI]: | 1407163884 |
| Last Name Of The Provider | ANDAR |
| First Name Of The Provider | MARIAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1792 GARNET AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921093350 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 499 |
| Number Of Medicare Beneficiaries | 256 |
| Total Submitted Charge Amount | 18204.12 |
| Total Medicare Allowed Amount | 16942.47 |
| Total Medicare Payment Amount | 13971.75 |
| Total Medicare Standardized Payment Amount | 15591.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 197 |
| Number Of Medicare Beneficiaries With Drug Services | 181 |
| Total Drug Submitted ChargeAmount | 5858.12 |
| Total Drug Medicare AllowedAmount | 5798.84 |
| Total Drug Medicare PaymentAmount | 5680.25 |
| Total Drug Medicare Standardized Payment Amount | 5680.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 302 |
| Number Of Medicare Beneficiaries With Medical Services | 256 |
| Total Medical Submitted Charge Amount | 12346 |
| Total Medical Medicare Allowed Amount | 11143.63 |
| Total Medical Medicare Payment Amount | 8291.5 |
| Total Medical Medicare Standardized Payment Amount | 9911.64 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 146 |
| Number Of Male Beneficiaries | 110 |
| Number Of Non Hispanic White Beneficiaries | 241 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7865 |