National Provider Identifier [NPI]: |
1548466287 |
Last Name Of The Provider |
RAJ |
First Name Of The Provider |
MANU |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2810 W SAINT ISABEL ST |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336076375 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1647 |
Number Of Medicare Beneficiaries |
435 |
Total Submitted Charge Amount |
243879 |
Total Medicare Allowed Amount |
172070.41 |
Total Medicare Payment Amount |
134171.34 |
Total Medicare Standardized Payment Amount |
133640.22 |
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 |
14 |
Number Of Medical Services |
1647 |
Number Of Medicare Beneficiaries With Medical Services |
435 |
Total Medical Submitted Charge Amount |
243879 |
Total Medical Medicare Allowed Amount |
172070.41 |
Total Medical Medicare Payment Amount |
134171.34 |
Total Medical Medicare Standardized Payment Amount |
133640.22 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
214 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
77 |
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 |
259 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
176 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
3.1717 |