National Provider Identifier [NPI]: |
1013079615 |
Last Name Of The Provider |
NAYAK |
First Name Of The Provider |
GURURAJ |
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 |
701 BLUEBIRD BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT VALLEY |
Zip Code Of The Provider |
310305085 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
680 |
Number Of Medicare Beneficiaries |
141 |
Total Submitted Charge Amount |
78868 |
Total Medicare Allowed Amount |
52196.81 |
Total Medicare Payment Amount |
40777.51 |
Total Medicare Standardized Payment Amount |
45121.31 |
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 |
24 |
Number Of Medical Services |
680 |
Number Of Medicare Beneficiaries With Medical Services |
141 |
Total Medical Submitted Charge Amount |
78868 |
Total Medical Medicare Allowed Amount |
52196.81 |
Total Medical Medicare Payment Amount |
40777.51 |
Total Medical Medicare Standardized Payment Amount |
45121.31 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
73 |
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 |
76 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.9391 |