National Provider Identifier [NPI]: |
1285886747 |
Last Name Of The Provider |
DALELA |
First Name Of The Provider |
SANJEEV |
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 |
506 6TH STREET |
Street Address 2 Of The Provider |
NY METHODIST HOSPITAL |
City Of The Provider |
BROOKLYN |
Zip Code Of The Provider |
112153609 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
240 |
Number Of Medicare Beneficiaries |
204 |
Total Submitted Charge Amount |
178251 |
Total Medicare Allowed Amount |
56001.07 |
Total Medicare Payment Amount |
43357.5 |
Total Medicare Standardized Payment Amount |
44981.49 |
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 |
61 |
Number Of Medical Services |
240 |
Number Of Medicare Beneficiaries With Medical Services |
204 |
Total Medical Submitted Charge Amount |
178251 |
Total Medical Medicare Allowed Amount |
56001.07 |
Total Medical Medicare Payment Amount |
43357.5 |
Total Medical Medicare Standardized Payment Amount |
44981.49 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
116 |
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 |
138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8135 |