| National Provider Identifier [NPI]: | 1154573590 |
| Last Name Of The Provider | WASFI |
| First Name Of The Provider | MARYAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2211 LOMAS NE MSC10 5550 |
| Street Address 2 Of The Provider | |
| City Of The Provider | ABUQUERQUE |
| Zip Code Of The Provider | 871310001 |
| State Code Of The Provider | NM |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 98 |
| Number Of Medicare Beneficiaries | 48 |
| Total Submitted Charge Amount | 8573 |
| Total Medicare Allowed Amount | 5605.69 |
| Total Medicare Payment Amount | 4492.49 |
| Total Medicare Standardized Payment Amount | 4326.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 21 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 630 |
| Total Drug Medicare AllowedAmount | 502.46 |
| Total Drug Medicare PaymentAmount | 492.38 |
| Total Drug Medicare Standardized Payment Amount | 492.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 77 |
| Number Of Medicare Beneficiaries With Medical Services | 48 |
| Total Medical Submitted Charge Amount | 7943 |
| Total Medical Medicare Allowed Amount | 5103.23 |
| Total Medical Medicare Payment Amount | 4000.11 |
| Total Medical Medicare Standardized Payment Amount | 3834.38 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 25 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 33 |
| Number Of Male Beneficiaries | 15 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0941 |