National Provider Identifier [NPI]: |
1861559551 |
Last Name Of The Provider |
MANI |
First Name Of The Provider |
GEETHALAKSHMI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1601 NW 114TH STREET |
Street Address 2 Of The Provider |
SUITE 257 |
City Of The Provider |
CLIVE |
Zip Code Of The Provider |
503257036 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
111 |
Number Of Services |
4207 |
Number Of Medicare Beneficiaries |
496 |
Total Submitted Charge Amount |
282410.51 |
Total Medicare Allowed Amount |
130554.41 |
Total Medicare Payment Amount |
97922.02 |
Total Medicare Standardized Payment Amount |
106101.99 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
203 |
Number Of Medicare Beneficiaries With Drug Services |
118 |
Total Drug Submitted ChargeAmount |
4337 |
Total Drug Medicare AllowedAmount |
3245.29 |
Total Drug Medicare PaymentAmount |
3132.97 |
Total Drug Medicare Standardized Payment Amount |
3132.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
96 |
Number Of Medical Services |
4004 |
Number Of Medicare Beneficiaries With Medical Services |
496 |
Total Medical Submitted Charge Amount |
278073.51 |
Total Medical Medicare Allowed Amount |
127309.12 |
Total Medical Medicare Payment Amount |
94789.05 |
Total Medical Medicare Standardized Payment Amount |
102969.02 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
199 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
346 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
431 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0973 |