| National Provider Identifier [NPI]: | 1184762122 |
| Last Name Of The Provider | WANI |
| First Name Of The Provider | SHOBHA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3075 GOVERNORS PLACE BLVD |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | DAYTON |
| Zip Code Of The Provider | 454091323 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 35449 |
| Number Of Medicare Beneficiaries | 360 |
| Total Submitted Charge Amount | 1557704 |
| Total Medicare Allowed Amount | 936286.67 |
| Total Medicare Payment Amount | 712711.13 |
| Total Medicare Standardized Payment Amount | 717328.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 22 |
| Number Of Drug Services | 33470 |
| Number Of Medicare Beneficiaries With Drug Services | 183 |
| Total Drug Submitted ChargeAmount | 1142172 |
| Total Drug Medicare AllowedAmount | 781540.51 |
| Total Drug Medicare PaymentAmount | 599923.98 |
| Total Drug Medicare Standardized Payment Amount | 599923.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 1979 |
| Number Of Medicare Beneficiaries With Medical Services | 360 |
| Total Medical Submitted Charge Amount | 415532 |
| Total Medical Medicare Allowed Amount | 154746.16 |
| Total Medical Medicare Payment Amount | 112787.15 |
| Total Medical Medicare Standardized Payment Amount | 117404.83 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 273 |
| Number Of Male Beneficiaries | 87 |
| Number Of Non Hispanic White Beneficiaries | 313 |
| Number Of Black or African American Beneficiaries | 36 |
| 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 | 308 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 30 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2206 |