National Provider Identifier [NPI]: |
1629003652 |
Last Name Of The Provider |
KRAJISNIK |
First Name Of The Provider |
SANJA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
215 W JANSS RD |
Street Address 2 Of The Provider |
PATHOLOGY DEPT |
City Of The Provider |
THOUSAND OAKS |
Zip Code Of The Provider |
913601847 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1526 |
Number Of Medicare Beneficiaries |
410 |
Total Submitted Charge Amount |
235545 |
Total Medicare Allowed Amount |
54885.24 |
Total Medicare Payment Amount |
42915.1 |
Total Medicare Standardized Payment Amount |
31722.26 |
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 |
27 |
Number Of Medical Services |
1526 |
Number Of Medicare Beneficiaries With Medical Services |
410 |
Total Medical Submitted Charge Amount |
235545 |
Total Medical Medicare Allowed Amount |
54885.24 |
Total Medical Medicare Payment Amount |
42915.1 |
Total Medical Medicare Standardized Payment Amount |
31722.26 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
224 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
345 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
13 |
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
360 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.8025 |