National Provider Identifier [NPI]: |
1194967984 |
Last Name Of The Provider |
PONNAGANTI |
First Name Of The Provider |
VAMSI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1300 MICCOSUKEE RD |
Street Address 2 Of The Provider |
TALLAHASSEE MEMORIAL HOSPITALIST GROUP |
City Of The Provider |
TALLAHASSEE |
Zip Code Of The Provider |
323085054 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
944 |
Number Of Medicare Beneficiaries |
335 |
Total Submitted Charge Amount |
150832.5 |
Total Medicare Allowed Amount |
89840.36 |
Total Medicare Payment Amount |
70232.74 |
Total Medicare Standardized Payment Amount |
69695.82 |
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 |
20 |
Number Of Medical Services |
944 |
Number Of Medicare Beneficiaries With Medical Services |
335 |
Total Medical Submitted Charge Amount |
150832.5 |
Total Medical Medicare Allowed Amount |
89840.36 |
Total Medical Medicare Payment Amount |
70232.74 |
Total Medical Medicare Standardized Payment Amount |
69695.82 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
147 |
Number Of Non Hispanic White Beneficiaries |
247 |
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 |
207 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.1861 |