National Provider Identifier [NPI]: |
1871552711 |
Last Name Of The Provider |
CHOUDHARY |
First Name Of The Provider |
CUCKOO |
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 |
132 S 10TH ST |
Street Address 2 Of The Provider |
480 MAIN BUILDING |
City Of The Provider |
PHILA |
Zip Code Of The Provider |
191075244 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
651 |
Number Of Medicare Beneficiaries |
335 |
Total Submitted Charge Amount |
313815 |
Total Medicare Allowed Amount |
90670.12 |
Total Medicare Payment Amount |
67252.08 |
Total Medicare Standardized Payment Amount |
63813.74 |
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 |
28 |
Number Of Medical Services |
651 |
Number Of Medicare Beneficiaries With Medical Services |
335 |
Total Medical Submitted Charge Amount |
313815 |
Total Medical Medicare Allowed Amount |
90670.12 |
Total Medical Medicare Payment Amount |
67252.08 |
Total Medical Medicare Standardized Payment Amount |
63813.74 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
228 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
215 |
Number Of Black or African American Beneficiaries |
91 |
Number Of AsianPacific Islander Beneficiaries |
14 |
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 |
270 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6565 |