National Provider Identifier [NPI]: |
1063729564 |
Last Name Of The Provider |
UPPALURI |
First Name Of The Provider |
KALYAN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 S BALLENGER HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
FLINT |
Zip Code Of The Provider |
485323638 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
854 |
Number Of Medicare Beneficiaries |
346 |
Total Submitted Charge Amount |
231183 |
Total Medicare Allowed Amount |
88015.12 |
Total Medicare Payment Amount |
68802.68 |
Total Medicare Standardized Payment Amount |
70560.24 |
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 |
854 |
Number Of Medicare Beneficiaries With Medical Services |
346 |
Total Medical Submitted Charge Amount |
231183 |
Total Medical Medicare Allowed Amount |
88015.12 |
Total Medical Medicare Payment Amount |
68802.68 |
Total Medical Medicare Standardized Payment Amount |
70560.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
224 |
Number Of Male Beneficiaries |
122 |
Number Of Non Hispanic White Beneficiaries |
277 |
Number Of Black or African American Beneficiaries |
54 |
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 |
226 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
120 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
26 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
71 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.4246 |