National Provider Identifier [NPI]: |
1154316354 |
Last Name Of The Provider |
HEJEEBU |
First Name Of The Provider |
SRINI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3355 GLENDALE AVE |
Street Address 2 Of The Provider |
MEDICINE |
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
436142426 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
1617 |
Number Of Medicare Beneficiaries |
407 |
Total Submitted Charge Amount |
291330 |
Total Medicare Allowed Amount |
138500.49 |
Total Medicare Payment Amount |
104550.09 |
Total Medicare Standardized Payment Amount |
107038.65 |
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 |
40 |
Number Of Medical Services |
1617 |
Number Of Medicare Beneficiaries With Medical Services |
407 |
Total Medical Submitted Charge Amount |
291330 |
Total Medical Medicare Allowed Amount |
138500.49 |
Total Medical Medicare Payment Amount |
104550.09 |
Total Medical Medicare Standardized Payment Amount |
107038.65 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
148 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
222 |
Number Of Male Beneficiaries |
185 |
Number Of Non Hispanic White Beneficiaries |
294 |
Number Of Black or African American Beneficiaries |
96 |
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 |
222 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
185 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.3012 |