National Provider Identifier [NPI]: |
1346254497 |
Last Name Of The Provider |
SAWH |
First Name Of The Provider |
ANNIL |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
841 OAKLEY SEAVER DR |
Street Address 2 Of The Provider |
UNIT A |
City Of The Provider |
CLERMONT |
Zip Code Of The Provider |
347111971 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1349 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
213047.04 |
Total Medicare Allowed Amount |
108605.63 |
Total Medicare Payment Amount |
81563.62 |
Total Medicare Standardized Payment Amount |
79247.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
87 |
Number Of Medicare Beneficiaries With Drug Services |
75 |
Total Drug Submitted ChargeAmount |
5565 |
Total Drug Medicare AllowedAmount |
898.6 |
Total Drug Medicare PaymentAmount |
872.18 |
Total Drug Medicare Standardized Payment Amount |
872.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
1262 |
Number Of Medicare Beneficiaries With Medical Services |
291 |
Total Medical Submitted Charge Amount |
207482.04 |
Total Medical Medicare Allowed Amount |
107707.03 |
Total Medical Medicare Payment Amount |
80691.44 |
Total Medical Medicare Standardized Payment Amount |
78374.84 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
148 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
175 |
Number Of Black or African American Beneficiaries |
47 |
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
212 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4636 |