National Provider Identifier [NPI]: |
1508803339 |
Last Name Of The Provider |
VASIREDDY |
First Name Of The Provider |
PRASAD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 N 1ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627810001 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
179 |
Number Of Services |
6057 |
Number Of Medicare Beneficiaries |
2932 |
Total Submitted Charge Amount |
1016116 |
Total Medicare Allowed Amount |
161945.43 |
Total Medicare Payment Amount |
127578.44 |
Total Medicare Standardized Payment Amount |
131079.82 |
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 |
179 |
Number Of Medical Services |
6057 |
Number Of Medicare Beneficiaries With Medical Services |
2932 |
Total Medical Submitted Charge Amount |
1016116 |
Total Medical Medicare Allowed Amount |
161945.43 |
Total Medical Medicare Payment Amount |
127578.44 |
Total Medical Medicare Standardized Payment Amount |
131079.82 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
532 |
Number Of Beneficiaries Age 65 to 74 |
1037 |
Number Of Beneficiaries Age 75 to 84 |
863 |
Number Of Beneficiaries Age Greater 84 |
500 |
Number Of Female Beneficiaries |
1810 |
Number Of Male Beneficiaries |
1122 |
Number Of Non Hispanic White Beneficiaries |
2837 |
Number Of Black or African American Beneficiaries |
55 |
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 |
22 |
Number Of Beneficiaries With Medicare Only Entitlement |
2034 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
898 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.364 |