National Provider Identifier [NPI]: |
1083756852 |
Last Name Of The Provider |
THIRUMALA |
First Name Of The Provider |
KRISHNA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3599 UNIVERSITY BLVD S |
Street Address 2 Of The Provider |
BUILDING 300 |
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322164252 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
210 |
Number Of Services |
8289 |
Number Of Medicare Beneficiaries |
5555 |
Total Submitted Charge Amount |
1030933 |
Total Medicare Allowed Amount |
251506.63 |
Total Medicare Payment Amount |
194596.43 |
Total Medicare Standardized Payment Amount |
195595.74 |
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 |
210 |
Number Of Medical Services |
8289 |
Number Of Medicare Beneficiaries With Medical Services |
5555 |
Total Medical Submitted Charge Amount |
1030933 |
Total Medical Medicare Allowed Amount |
251506.63 |
Total Medical Medicare Payment Amount |
194596.43 |
Total Medical Medicare Standardized Payment Amount |
195595.74 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
1021 |
Number Of Beneficiaries Age 65 to 74 |
2046 |
Number Of Beneficiaries Age 75 to 84 |
1584 |
Number Of Beneficiaries Age Greater 84 |
904 |
Number Of Female Beneficiaries |
3375 |
Number Of Male Beneficiaries |
2180 |
Number Of Non Hispanic White Beneficiaries |
4368 |
Number Of Black or African American Beneficiaries |
839 |
Number Of AsianPacific Islander Beneficiaries |
81 |
Number Of Hispanic Beneficiaries |
200 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
4101 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1454 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.0012 |