National Provider Identifier [NPI]: |
1922034982 |
Last Name Of The Provider |
SABNIS |
First Name Of The Provider |
SUSHIL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3003 W GOOD HOPE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532092042 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
138 |
Number Of Services |
7689 |
Number Of Medicare Beneficiaries |
1811 |
Total Submitted Charge Amount |
1750927 |
Total Medicare Allowed Amount |
193300.41 |
Total Medicare Payment Amount |
147786.12 |
Total Medicare Standardized Payment Amount |
158005.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
5065 |
Number Of Medicare Beneficiaries With Drug Services |
72 |
Total Drug Submitted ChargeAmount |
12717 |
Total Drug Medicare AllowedAmount |
1597.3 |
Total Drug Medicare PaymentAmount |
1176.85 |
Total Drug Medicare Standardized Payment Amount |
1176.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
134 |
Number Of Medical Services |
2624 |
Number Of Medicare Beneficiaries With Medical Services |
1811 |
Total Medical Submitted Charge Amount |
1738210 |
Total Medical Medicare Allowed Amount |
191703.11 |
Total Medical Medicare Payment Amount |
146609.27 |
Total Medical Medicare Standardized Payment Amount |
156829.01 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
241 |
Number Of Beneficiaries Age 65 to 74 |
817 |
Number Of Beneficiaries Age 75 to 84 |
537 |
Number Of Beneficiaries Age Greater 84 |
216 |
Number Of Female Beneficiaries |
1285 |
Number Of Male Beneficiaries |
526 |
Number Of Non Hispanic White Beneficiaries |
1426 |
Number Of Black or African American Beneficiaries |
308 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
41 |
Number Of Beneficiaries With Medicare Only Entitlement |
1547 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
264 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1072 |