National Provider Identifier [NPI]: |
1932274461 |
Last Name Of The Provider |
DALAL |
First Name Of The Provider |
SURINDER |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
770 PINE ST |
Street Address 2 Of The Provider |
SUITE 560 |
City Of The Provider |
MACON |
Zip Code Of The Provider |
312012173 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
3182 |
Number Of Medicare Beneficiaries |
624 |
Total Submitted Charge Amount |
392921 |
Total Medicare Allowed Amount |
307519.42 |
Total Medicare Payment Amount |
234549.97 |
Total Medicare Standardized Payment Amount |
248779.19 |
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 |
25 |
Number Of Medical Services |
3182 |
Number Of Medicare Beneficiaries With Medical Services |
624 |
Total Medical Submitted Charge Amount |
392921 |
Total Medical Medicare Allowed Amount |
307519.42 |
Total Medical Medicare Payment Amount |
234549.97 |
Total Medical Medicare Standardized Payment Amount |
248779.19 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
141 |
Number Of Beneficiaries Age 65 to 74 |
238 |
Number Of Beneficiaries Age 75 to 84 |
180 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
311 |
Number Of Male Beneficiaries |
313 |
Number Of Non Hispanic White Beneficiaries |
380 |
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 |
420 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
204 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
63 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.727 |