National Provider Identifier [NPI]: |
1902067960 |
Last Name Of The Provider |
AWAN |
First Name Of The Provider |
KANWAL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5230 CENTRE AVENUE |
Street Address 2 Of The Provider |
ROOM 210 SON |
City Of The Provider |
PITTSBURGH |
Zip Code Of The Provider |
15232 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Geriatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1055 |
Number Of Medicare Beneficiaries |
290 |
Total Submitted Charge Amount |
211982 |
Total Medicare Allowed Amount |
112836.54 |
Total Medicare Payment Amount |
87898.82 |
Total Medicare Standardized Payment Amount |
83074.78 |
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 |
14 |
Number Of Medical Services |
1055 |
Number Of Medicare Beneficiaries With Medical Services |
290 |
Total Medical Submitted Charge Amount |
211982 |
Total Medical Medicare Allowed Amount |
112836.54 |
Total Medical Medicare Payment Amount |
87898.82 |
Total Medical Medicare Standardized Payment Amount |
83074.78 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
107 |
Number Of Female Beneficiaries |
182 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
251 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
218 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
69 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
53 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
1.8962 |