National Provider Identifier [NPI]: |
1235321704 |
Last Name Of The Provider |
RANA |
First Name Of The Provider |
SAPANA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10961 S KEDZIE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606552219 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
145.5 |
Number Of Medicare Beneficiaries |
70 |
Total Submitted Charge Amount |
23393.26 |
Total Medicare Allowed Amount |
10440.32 |
Total Medicare Payment Amount |
6815.97 |
Total Medicare Standardized Payment Amount |
6313.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
20.5 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
479 |
Total Drug Medicare AllowedAmount |
76.49 |
Total Drug Medicare PaymentAmount |
60 |
Total Drug Medicare Standardized Payment Amount |
60 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
125 |
Number Of Medicare Beneficiaries With Medical Services |
70 |
Total Medical Submitted Charge Amount |
22914.26 |
Total Medical Medicare Allowed Amount |
10363.83 |
Total Medical Medicare Payment Amount |
6755.97 |
Total Medical Medicare Standardized Payment Amount |
6253.81 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
11 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
51 |
Number Of Male Beneficiaries |
19 |
Number Of Non Hispanic White Beneficiaries |
52 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
26 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9623 |