| National Provider Identifier [NPI]: | 1942387931 |
| Last Name Of The Provider | DEWAN |
| First Name Of The Provider | MEERA |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11912 ELM ST |
| Street Address 2 Of The Provider | SUITE 26 |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681444443 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1424 |
| Number Of Medicare Beneficiaries | 100 |
| Total Submitted Charge Amount | 107757 |
| Total Medicare Allowed Amount | 51274.29 |
| Total Medicare Payment Amount | 38222.75 |
| Total Medicare Standardized Payment Amount | 42449.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1565 |
| Total Drug Medicare AllowedAmount | 695.58 |
| Total Drug Medicare PaymentAmount | 679.53 |
| Total Drug Medicare Standardized Payment Amount | 679.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1383 |
| Number Of Medicare Beneficiaries With Medical Services | 100 |
| Total Medical Submitted Charge Amount | 106192 |
| Total Medical Medicare Allowed Amount | 50578.71 |
| Total Medical Medicare Payment Amount | 37543.22 |
| Total Medical Medicare Standardized Payment Amount | 41770.15 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 51 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 69 |
| Number Of Male Beneficiaries | 31 |
| Number Of Non Hispanic White Beneficiaries | 87 |
| 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 | 87 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8447 |