National Provider Identifier [NPI]: |
1093854366 |
Last Name Of The Provider |
RAJU |
First Name Of The Provider |
RYAN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2401 S 31ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TEMPLE |
Zip Code Of The Provider |
76508 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
621 |
Number Of Medicare Beneficiaries |
162 |
Total Submitted Charge Amount |
414610.56 |
Total Medicare Allowed Amount |
105494.29 |
Total Medicare Payment Amount |
80641.78 |
Total Medicare Standardized Payment Amount |
81165.28 |
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 |
91 |
Number Of Medical Services |
621 |
Number Of Medicare Beneficiaries With Medical Services |
162 |
Total Medical Submitted Charge Amount |
414610.56 |
Total Medical Medicare Allowed Amount |
105494.29 |
Total Medical Medicare Payment Amount |
80641.78 |
Total Medical Medicare Standardized Payment Amount |
81165.28 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
124 |
Number Of Black or African American Beneficiaries |
18 |
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 |
113 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8119 |