National Provider Identifier [NPI]: |
1073542346 |
Last Name Of The Provider |
GUTTIKONDA |
First Name Of The Provider |
DEEPAK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8075 N SHADELAND AVE |
Street Address 2 Of The Provider |
SUITE 120 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462502693 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
138 |
Number Of Services |
3097 |
Number Of Medicare Beneficiaries |
1419 |
Total Submitted Charge Amount |
2575651.44 |
Total Medicare Allowed Amount |
571636.78 |
Total Medicare Payment Amount |
433782.12 |
Total Medicare Standardized Payment Amount |
466523.52 |
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 |
138 |
Number Of Medical Services |
3097 |
Number Of Medicare Beneficiaries With Medical Services |
1419 |
Total Medical Submitted Charge Amount |
2575651.44 |
Total Medical Medicare Allowed Amount |
571636.78 |
Total Medical Medicare Payment Amount |
433782.12 |
Total Medical Medicare Standardized Payment Amount |
466523.52 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
246 |
Number Of Beneficiaries Age 65 to 74 |
527 |
Number Of Beneficiaries Age 75 to 84 |
446 |
Number Of Beneficiaries Age Greater 84 |
200 |
Number Of Female Beneficiaries |
716 |
Number Of Male Beneficiaries |
703 |
Number Of Non Hispanic White Beneficiaries |
1176 |
Number Of Black or African American Beneficiaries |
204 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1059 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
360 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.8599 |