National Provider Identifier [NPI]: |
1427208990 |
Last Name Of The Provider |
GOPALUNI |
First Name Of The Provider |
SRIVALLI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
605 E HOLLAND AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
SPOKANE |
Zip Code Of The Provider |
992182225 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
134 |
Number Of Services |
145139 |
Number Of Medicare Beneficiaries |
654 |
Total Submitted Charge Amount |
6706540.97 |
Total Medicare Allowed Amount |
1911110.31 |
Total Medicare Payment Amount |
1493655.97 |
Total Medicare Standardized Payment Amount |
1488714.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
67 |
Number Of Drug Services |
136793 |
Number Of Medicare Beneficiaries With Drug Services |
240 |
Total Drug Submitted ChargeAmount |
4875013.97 |
Total Drug Medicare AllowedAmount |
1326167.14 |
Total Drug Medicare PaymentAmount |
1038208.95 |
Total Drug Medicare Standardized Payment Amount |
1038208.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
67 |
Number Of Medical Services |
8346 |
Number Of Medicare Beneficiaries With Medical Services |
654 |
Total Medical Submitted Charge Amount |
1831527 |
Total Medical Medicare Allowed Amount |
584943.17 |
Total Medical Medicare Payment Amount |
455447.02 |
Total Medical Medicare Standardized Payment Amount |
450505.87 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
269 |
Number Of Beneficiaries Age 75 to 84 |
225 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
373 |
Number Of Male Beneficiaries |
281 |
Number Of Non Hispanic White Beneficiaries |
613 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
17 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
543 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
51 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.8865 |