National Provider Identifier [NPI]: |
1043231046 |
Last Name Of The Provider |
KUNAM |
First Name Of The Provider |
SRINIVASA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3700 KOLBE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LORAIN |
Zip Code Of The Provider |
440531611 |
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 |
28 |
Number Of Services |
1405 |
Number Of Medicare Beneficiaries |
430 |
Total Submitted Charge Amount |
256295 |
Total Medicare Allowed Amount |
129087.02 |
Total Medicare Payment Amount |
98716.73 |
Total Medicare Standardized Payment Amount |
100484.17 |
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 |
28 |
Number Of Medical Services |
1405 |
Number Of Medicare Beneficiaries With Medical Services |
430 |
Total Medical Submitted Charge Amount |
256295 |
Total Medical Medicare Allowed Amount |
129087.02 |
Total Medical Medicare Payment Amount |
98716.73 |
Total Medical Medicare Standardized Payment Amount |
100484.17 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
228 |
Number Of Male Beneficiaries |
202 |
Number Of Non Hispanic White Beneficiaries |
356 |
Number Of Black or African American Beneficiaries |
39 |
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 |
266 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
164 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
49 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
1.9292 |