| National Provider Identifier [NPI]: | 1477643013 |
| Last Name Of The Provider | GADIWALLA |
| First Name Of The Provider | SEEMA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1132 ANNAPOLIS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ODENTON |
| Zip Code Of The Provider | 211131647 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 1146 |
| Number Of Medicare Beneficiaries | 230 |
| Total Submitted Charge Amount | 160685 |
| Total Medicare Allowed Amount | 71181.59 |
| Total Medicare Payment Amount | 51982.49 |
| Total Medicare Standardized Payment Amount | 49434.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 5552 |
| Total Drug Medicare AllowedAmount | 2512.88 |
| Total Drug Medicare PaymentAmount | 2400.82 |
| Total Drug Medicare Standardized Payment Amount | 2400.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1029 |
| Number Of Medicare Beneficiaries With Medical Services | 230 |
| Total Medical Submitted Charge Amount | 155133 |
| Total Medical Medicare Allowed Amount | 68668.71 |
| Total Medical Medicare Payment Amount | 49581.67 |
| Total Medical Medicare Standardized Payment Amount | 47033.93 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 150 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | 91 |
| Number Of Black or African American Beneficiaries | 123 |
| 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 | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1572 |