National Provider Identifier [NPI]: |
1447365887 |
Last Name Of The Provider |
SADIQ |
First Name Of The Provider |
RIZWAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
240 SPRUCE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRIDLEY |
Zip Code Of The Provider |
959482216 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
1031 |
Number Of Medicare Beneficiaries |
329 |
Total Submitted Charge Amount |
124979 |
Total Medicare Allowed Amount |
85550.66 |
Total Medicare Payment Amount |
59540.12 |
Total Medicare Standardized Payment Amount |
58799.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
94 |
Number Of Medicare Beneficiaries With Drug Services |
72 |
Total Drug Submitted ChargeAmount |
2794 |
Total Drug Medicare AllowedAmount |
1707.41 |
Total Drug Medicare PaymentAmount |
1646 |
Total Drug Medicare Standardized Payment Amount |
1646 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
937 |
Number Of Medicare Beneficiaries With Medical Services |
328 |
Total Medical Submitted Charge Amount |
122185 |
Total Medical Medicare Allowed Amount |
83843.25 |
Total Medical Medicare Payment Amount |
57894.12 |
Total Medical Medicare Standardized Payment Amount |
57153.53 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
164 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
309 |
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 |
202 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0766 |