National Provider Identifier [NPI]: |
1225014111 |
Last Name Of The Provider |
CUDAHY |
First Name Of The Provider |
TERENCE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2560 N. SHADELAND AVENUE |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462191706 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
3967 |
Number Of Medicare Beneficiaries |
1294 |
Total Submitted Charge Amount |
869005.58 |
Total Medicare Allowed Amount |
164114.86 |
Total Medicare Payment Amount |
128229.3 |
Total Medicare Standardized Payment Amount |
81491 |
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 |
31 |
Number Of Medical Services |
3967 |
Number Of Medicare Beneficiaries With Medical Services |
1294 |
Total Medical Submitted Charge Amount |
869005.58 |
Total Medical Medicare Allowed Amount |
164114.86 |
Total Medical Medicare Payment Amount |
128229.3 |
Total Medical Medicare Standardized Payment Amount |
81491 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
180 |
Number Of Beneficiaries Age 65 to 74 |
568 |
Number Of Beneficiaries Age 75 to 84 |
398 |
Number Of Beneficiaries Age Greater 84 |
148 |
Number Of Female Beneficiaries |
908 |
Number Of Male Beneficiaries |
386 |
Number Of Non Hispanic White Beneficiaries |
1166 |
Number Of Black or African American Beneficiaries |
100 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
1032 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
262 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
46 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6602 |