National Provider Identifier [NPI]: |
1649285453 |
Last Name Of The Provider |
NAGENDRA |
First Name Of The Provider |
SANJAI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 N FIRST STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
62781 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
2043 |
Number Of Medicare Beneficiaries |
568 |
Total Submitted Charge Amount |
499461.7 |
Total Medicare Allowed Amount |
74974.02 |
Total Medicare Payment Amount |
57800.35 |
Total Medicare Standardized Payment Amount |
46897.02 |
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 |
28 |
Number Of Medical Services |
2043 |
Number Of Medicare Beneficiaries With Medical Services |
568 |
Total Medical Submitted Charge Amount |
499461.7 |
Total Medical Medicare Allowed Amount |
74974.02 |
Total Medical Medicare Payment Amount |
57800.35 |
Total Medical Medicare Standardized Payment Amount |
46897.02 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
243 |
Number Of Beneficiaries Age 75 to 84 |
177 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
292 |
Number Of Male Beneficiaries |
276 |
Number Of Non Hispanic White Beneficiaries |
531 |
Number Of Black or African American Beneficiaries |
26 |
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 |
472 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
96 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5444 |