National Provider Identifier [NPI]: |
1003884404 |
Last Name Of The Provider |
KESA |
First Name Of The Provider |
SRINIVASU |
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 |
3471 MUIRFIELD WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
CARMEL |
Zip Code Of The Provider |
46032 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
489 |
Number Of Medicare Beneficiaries |
369 |
Total Submitted Charge Amount |
280977 |
Total Medicare Allowed Amount |
45196.45 |
Total Medicare Payment Amount |
34275.37 |
Total Medicare Standardized Payment Amount |
35770.05 |
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 |
16 |
Number Of Medical Services |
489 |
Number Of Medicare Beneficiaries With Medical Services |
369 |
Total Medical Submitted Charge Amount |
280977 |
Total Medical Medicare Allowed Amount |
45196.45 |
Total Medical Medicare Payment Amount |
34275.37 |
Total Medical Medicare Standardized Payment Amount |
35770.05 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
159 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
166 |
Number Of Non Hispanic White Beneficiaries |
357 |
Number Of Black or African American Beneficiaries |
|
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 |
171 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
198 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6431 |