National Provider Identifier [NPI]: |
1285836098 |
Last Name Of The Provider |
CHALLAGUNDLA |
First Name Of The Provider |
SUNEETHA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4411 MEDICAL DR |
Street Address 2 Of The Provider |
STE. 100 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782293822 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
182 |
Number Of Services |
247322 |
Number Of Medicare Beneficiaries |
852 |
Total Submitted Charge Amount |
7752841 |
Total Medicare Allowed Amount |
2267685.44 |
Total Medicare Payment Amount |
1778599.37 |
Total Medicare Standardized Payment Amount |
1809768.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
64 |
Number Of Drug Services |
229924 |
Number Of Medicare Beneficiaries With Drug Services |
185 |
Total Drug Submitted ChargeAmount |
5390642 |
Total Drug Medicare AllowedAmount |
1560316.12 |
Total Drug Medicare PaymentAmount |
1221429.94 |
Total Drug Medicare Standardized Payment Amount |
1221429.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
118 |
Number Of Medical Services |
17398 |
Number Of Medicare Beneficiaries With Medical Services |
852 |
Total Medical Submitted Charge Amount |
2362199 |
Total Medical Medicare Allowed Amount |
707369.32 |
Total Medical Medicare Payment Amount |
557169.43 |
Total Medical Medicare Standardized Payment Amount |
588338.42 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
139 |
Number Of Beneficiaries Age 65 to 74 |
327 |
Number Of Beneficiaries Age 75 to 84 |
265 |
Number Of Beneficiaries Age Greater 84 |
121 |
Number Of Female Beneficiaries |
497 |
Number Of Male Beneficiaries |
355 |
Number Of Non Hispanic White Beneficiaries |
541 |
Number Of Black or African American Beneficiaries |
30 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
263 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
690 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
162 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.1504 |