National Provider Identifier [NPI]: |
1508865619 |
Last Name Of The Provider |
KHANNA |
First Name Of The Provider |
RAJESH |
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 |
903 NW WASHINGTON BLVD |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
HAMILTON |
Zip Code Of The Provider |
450136386 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1009 |
Number Of Medicare Beneficiaries |
244 |
Total Submitted Charge Amount |
129507 |
Total Medicare Allowed Amount |
78541.07 |
Total Medicare Payment Amount |
50957.72 |
Total Medicare Standardized Payment Amount |
53978.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
116 |
Number Of Medicare Beneficiaries With Drug Services |
59 |
Total Drug Submitted ChargeAmount |
3253 |
Total Drug Medicare AllowedAmount |
1206.81 |
Total Drug Medicare PaymentAmount |
1142.18 |
Total Drug Medicare Standardized Payment Amount |
1142.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
893 |
Number Of Medicare Beneficiaries With Medical Services |
244 |
Total Medical Submitted Charge Amount |
126254 |
Total Medical Medicare Allowed Amount |
77334.26 |
Total Medical Medicare Payment Amount |
49815.54 |
Total Medical Medicare Standardized Payment Amount |
52836.8 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
233 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.058 |