National Provider Identifier [NPI]: |
1245251255 |
Last Name Of The Provider |
ATTALURI |
First Name Of The Provider |
JAYALAKSHMI |
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 |
765 N KELLOGG ST |
Street Address 2 Of The Provider |
SUITE 205 |
City Of The Provider |
GALESBURG |
Zip Code Of The Provider |
614012875 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
2185 |
Number Of Medicare Beneficiaries |
298 |
Total Submitted Charge Amount |
418371 |
Total Medicare Allowed Amount |
214053.64 |
Total Medicare Payment Amount |
166984.76 |
Total Medicare Standardized Payment Amount |
169237.46 |
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 |
18 |
Number Of Medical Services |
2185 |
Number Of Medicare Beneficiaries With Medical Services |
298 |
Total Medical Submitted Charge Amount |
418371 |
Total Medical Medicare Allowed Amount |
214053.64 |
Total Medical Medicare Payment Amount |
166984.76 |
Total Medical Medicare Standardized Payment Amount |
169237.46 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
177 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
279 |
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 |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
53 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5506 |