National Provider Identifier [NPI]: |
1639171671 |
Last Name Of The Provider |
MISRA |
First Name Of The Provider |
HEATHER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2010 W 86TH ST |
Street Address 2 Of The Provider |
SUITE 111 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462601947 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
930 |
Number Of Medicare Beneficiaries |
373 |
Total Submitted Charge Amount |
219716 |
Total Medicare Allowed Amount |
91790.1 |
Total Medicare Payment Amount |
71569.82 |
Total Medicare Standardized Payment Amount |
70303.55 |
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 |
26 |
Number Of Medical Services |
930 |
Number Of Medicare Beneficiaries With Medical Services |
373 |
Total Medical Submitted Charge Amount |
219716 |
Total Medical Medicare Allowed Amount |
91790.1 |
Total Medical Medicare Payment Amount |
71569.82 |
Total Medical Medicare Standardized Payment Amount |
70303.55 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
189 |
Number Of Male Beneficiaries |
184 |
Number Of Non Hispanic White Beneficiaries |
312 |
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 |
272 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
55 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.1848 |