National Provider Identifier [NPI]: |
1891718276 |
Last Name Of The Provider |
MALDE |
First Name Of The Provider |
CHANDULAL |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5050 VILLA LINDE PKWY |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
FLINT |
Zip Code Of The Provider |
485323436 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
540 |
Number Of Medicare Beneficiaries |
98 |
Total Submitted Charge Amount |
43708 |
Total Medicare Allowed Amount |
29711.07 |
Total Medicare Payment Amount |
21485.45 |
Total Medicare Standardized Payment Amount |
22454.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
64 |
Number Of Medicare Beneficiaries With Drug Services |
49 |
Total Drug Submitted ChargeAmount |
1294 |
Total Drug Medicare AllowedAmount |
531.07 |
Total Drug Medicare PaymentAmount |
510.51 |
Total Drug Medicare Standardized Payment Amount |
510.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
476 |
Number Of Medicare Beneficiaries With Medical Services |
98 |
Total Medical Submitted Charge Amount |
42414 |
Total Medical Medicare Allowed Amount |
29180 |
Total Medical Medicare Payment Amount |
20974.94 |
Total Medical Medicare Standardized Payment Amount |
21944.16 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
43 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
66 |
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 |
98 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
13 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2617 |