National Provider Identifier [NPI]: |
1619913928 |
Last Name Of The Provider |
PUNEKY |
First Name Of The Provider |
LOUIS |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2500 NORTH STATE STREET |
Street Address 2 Of The Provider |
DEPARTMENT OF MEDICINE/DIVISION OF ONCOLOGY |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392164500 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
674 |
Number Of Medicare Beneficiaries |
240 |
Total Submitted Charge Amount |
162213 |
Total Medicare Allowed Amount |
83528.67 |
Total Medicare Payment Amount |
61674.34 |
Total Medicare Standardized Payment Amount |
66810.54 |
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 |
16 |
Number Of Medical Services |
674 |
Number Of Medicare Beneficiaries With Medical Services |
240 |
Total Medical Submitted Charge Amount |
162213 |
Total Medical Medicare Allowed Amount |
83528.67 |
Total Medical Medicare Payment Amount |
61674.34 |
Total Medical Medicare Standardized Payment Amount |
66810.54 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
125 |
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 |
120 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
120 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
73 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7782 |