National Provider Identifier [NPI]: |
1215168794 |
Last Name Of The Provider |
KUMAR |
First Name Of The Provider |
SRIKANT |
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 |
6644 E BAYWOOD AVE |
Street Address 2 Of The Provider |
BANNER BAYWOOD MEDICAL CENTER |
City Of The Provider |
MESA |
Zip Code Of The Provider |
85206 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1714 |
Number Of Medicare Beneficiaries |
852 |
Total Submitted Charge Amount |
409875 |
Total Medicare Allowed Amount |
206807.96 |
Total Medicare Payment Amount |
161126.16 |
Total Medicare Standardized Payment Amount |
162077.17 |
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 |
14 |
Number Of Medical Services |
1714 |
Number Of Medicare Beneficiaries With Medical Services |
852 |
Total Medical Submitted Charge Amount |
409875 |
Total Medical Medicare Allowed Amount |
206807.96 |
Total Medical Medicare Payment Amount |
161126.16 |
Total Medical Medicare Standardized Payment Amount |
162077.17 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
310 |
Number Of Beneficiaries Age 75 to 84 |
290 |
Number Of Beneficiaries Age Greater 84 |
170 |
Number Of Female Beneficiaries |
470 |
Number Of Male Beneficiaries |
382 |
Number Of Non Hispanic White Beneficiaries |
764 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
15 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
741 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.0117 |