National Provider Identifier [NPI]: |
1477553931 |
Last Name Of The Provider |
GOVINDAIAH |
First Name Of The Provider |
RENU |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1025 S 6TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627032403 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
3375 |
Number Of Medicare Beneficiaries |
181 |
Total Submitted Charge Amount |
48312.43 |
Total Medicare Allowed Amount |
41378.18 |
Total Medicare Payment Amount |
29329.58 |
Total Medicare Standardized Payment Amount |
30388.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
14 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
654.49 |
Total Drug Medicare AllowedAmount |
603.32 |
Total Drug Medicare PaymentAmount |
495.25 |
Total Drug Medicare Standardized Payment Amount |
495.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
3361 |
Number Of Medicare Beneficiaries With Medical Services |
181 |
Total Medical Submitted Charge Amount |
47657.94 |
Total Medical Medicare Allowed Amount |
40774.86 |
Total Medical Medicare Payment Amount |
28834.33 |
Total Medical Medicare Standardized Payment Amount |
29892.97 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
126 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
153 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
34 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8554 |