National Provider Identifier [NPI]: |
1538491105 |
Last Name Of The Provider |
RAM |
First Name Of The Provider |
SARAVANAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.D.S. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16311 VENTURA BLVD |
Street Address 2 Of The Provider |
SUITE 1250 |
City Of The Provider |
ENCINO |
Zip Code Of The Provider |
914362124 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Oral Surgery (dentists only) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
199 |
Number Of Medicare Beneficiaries |
99 |
Total Submitted Charge Amount |
33197 |
Total Medicare Allowed Amount |
26244.85 |
Total Medicare Payment Amount |
19737.14 |
Total Medicare Standardized Payment Amount |
18488.55 |
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 |
12 |
Number Of Medical Services |
199 |
Number Of Medicare Beneficiaries With Medical Services |
99 |
Total Medical Submitted Charge Amount |
33197 |
Total Medical Medicare Allowed Amount |
26244.85 |
Total Medical Medicare Payment Amount |
19737.14 |
Total Medical Medicare Standardized Payment Amount |
18488.55 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
38 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
42 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
21 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2062 |