National Provider Identifier [NPI]: |
1043599178 |
Last Name Of The Provider |
RAJAN |
First Name Of The Provider |
SANGEETHA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
130 DIVISION ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DERBY |
Zip Code Of The Provider |
064181326 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
265 |
Number Of Medicare Beneficiaries |
101 |
Total Submitted Charge Amount |
35527 |
Total Medicare Allowed Amount |
19512.54 |
Total Medicare Payment Amount |
16365.15 |
Total Medicare Standardized Payment Amount |
15438.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
1158 |
Total Drug Medicare AllowedAmount |
686.75 |
Total Drug Medicare PaymentAmount |
672.54 |
Total Drug Medicare Standardized Payment Amount |
672.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
242 |
Number Of Medicare Beneficiaries With Medical Services |
101 |
Total Medical Submitted Charge Amount |
34369 |
Total Medical Medicare Allowed Amount |
18825.79 |
Total Medical Medicare Payment Amount |
15692.61 |
Total Medical Medicare Standardized Payment Amount |
14765.94 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
82 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
39 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4032 |