National Provider Identifier [NPI]: |
1235173345 |
Last Name Of The Provider |
CHERUKU |
First Name Of The Provider |
SUNIL |
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 |
10205 DIANELLA LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
787593040 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1525 |
Number Of Medicare Beneficiaries |
170 |
Total Submitted Charge Amount |
381761.31 |
Total Medicare Allowed Amount |
122805.04 |
Total Medicare Payment Amount |
93662.37 |
Total Medicare Standardized Payment Amount |
96581.21 |
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 |
29 |
Number Of Medical Services |
1525 |
Number Of Medicare Beneficiaries With Medical Services |
170 |
Total Medical Submitted Charge Amount |
381761.31 |
Total Medical Medicare Allowed Amount |
122805.04 |
Total Medical Medicare Payment Amount |
93662.37 |
Total Medical Medicare Standardized Payment Amount |
96581.21 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
85 |
Number Of Non Hispanic White Beneficiaries |
104 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
3.0598 |