National Provider Identifier [NPI]: |
1205815669 |
Last Name Of The Provider |
AZIZI |
First Name Of The Provider |
PERCILLA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
515 WEKIVA COMMONS CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
APOPKA |
Zip Code Of The Provider |
327123645 |
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 |
13 |
Number Of Services |
1283 |
Number Of Medicare Beneficiaries |
431 |
Total Submitted Charge Amount |
262625 |
Total Medicare Allowed Amount |
140345.03 |
Total Medicare Payment Amount |
109741.38 |
Total Medicare Standardized Payment Amount |
109465.12 |
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 |
13 |
Number Of Medical Services |
1283 |
Number Of Medicare Beneficiaries With Medical Services |
431 |
Total Medical Submitted Charge Amount |
262625 |
Total Medical Medicare Allowed Amount |
140345.03 |
Total Medical Medicare Payment Amount |
109741.38 |
Total Medical Medicare Standardized Payment Amount |
109465.12 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
245 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
278 |
Number Of Black or African American Beneficiaries |
84 |
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 |
294 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
137 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
3.0276 |