National Provider Identifier [NPI]: |
1154382869 |
Last Name Of The Provider |
REDDY |
First Name Of The Provider |
SANTOSH |
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 |
50 N MEDICAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841320100 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
549 |
Number Of Medicare Beneficiaries |
218 |
Total Submitted Charge Amount |
116211.26 |
Total Medicare Allowed Amount |
55785.22 |
Total Medicare Payment Amount |
42746.31 |
Total Medicare Standardized Payment Amount |
44478.93 |
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 |
20 |
Number Of Medical Services |
549 |
Number Of Medicare Beneficiaries With Medical Services |
218 |
Total Medical Submitted Charge Amount |
116211.26 |
Total Medical Medicare Allowed Amount |
55785.22 |
Total Medical Medicare Payment Amount |
42746.31 |
Total Medical Medicare Standardized Payment Amount |
44478.93 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
152 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.4405 |