National Provider Identifier [NPI]: |
1588723860 |
Last Name Of The Provider |
SREJIC |
First Name Of The Provider |
UNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1515 HOLCOMBE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770304009 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
212 |
Number Of Medicare Beneficiaries |
186 |
Total Submitted Charge Amount |
481343.5 |
Total Medicare Allowed Amount |
64883.9 |
Total Medicare Payment Amount |
50963.89 |
Total Medicare Standardized Payment Amount |
47519.47 |
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 |
65 |
Number Of Medical Services |
212 |
Number Of Medicare Beneficiaries With Medical Services |
186 |
Total Medical Submitted Charge Amount |
481343.5 |
Total Medical Medicare Allowed Amount |
64883.9 |
Total Medical Medicare Payment Amount |
50963.89 |
Total Medical Medicare Standardized Payment Amount |
47519.47 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
136 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
121 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.822 |