National Provider Identifier [NPI]: |
1578623278 |
Last Name Of The Provider |
MADHIPATLA |
First Name Of The Provider |
VENU |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3131 S MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MOULTRIE |
Zip Code Of The Provider |
317686925 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
88 |
Number Of Services |
1273 |
Number Of Medicare Beneficiaries |
205 |
Total Submitted Charge Amount |
481230 |
Total Medicare Allowed Amount |
97421.55 |
Total Medicare Payment Amount |
73174.3 |
Total Medicare Standardized Payment Amount |
72661.94 |
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 |
88 |
Number Of Medical Services |
1273 |
Number Of Medicare Beneficiaries With Medical Services |
205 |
Total Medical Submitted Charge Amount |
481230 |
Total Medical Medicare Allowed Amount |
97421.55 |
Total Medical Medicare Payment Amount |
73174.3 |
Total Medical Medicare Standardized Payment Amount |
72661.94 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
179 |
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 |
120 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5925 |