National Provider Identifier [NPI]: |
1215972419 |
Last Name Of The Provider |
CHODIMELLA |
First Name Of The Provider |
VIDYASAGAR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4325 N JOSEY LN |
Street Address 2 Of The Provider |
SUITE 204, PLAZA 3 |
City Of The Provider |
CARROLLTON |
Zip Code Of The Provider |
750104635 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
5065 |
Number Of Medicare Beneficiaries |
898 |
Total Submitted Charge Amount |
623344.12 |
Total Medicare Allowed Amount |
412416.02 |
Total Medicare Payment Amount |
311609.62 |
Total Medicare Standardized Payment Amount |
344277.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
189 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
26064 |
Total Drug Medicare AllowedAmount |
9949.47 |
Total Drug Medicare PaymentAmount |
7685.12 |
Total Drug Medicare Standardized Payment Amount |
7685.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
4876 |
Number Of Medicare Beneficiaries With Medical Services |
898 |
Total Medical Submitted Charge Amount |
597280.12 |
Total Medical Medicare Allowed Amount |
402466.55 |
Total Medical Medicare Payment Amount |
303924.5 |
Total Medical Medicare Standardized Payment Amount |
336592.32 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
117 |
Number Of Beneficiaries Age 65 to 74 |
335 |
Number Of Beneficiaries Age 75 to 84 |
302 |
Number Of Beneficiaries Age Greater 84 |
144 |
Number Of Female Beneficiaries |
545 |
Number Of Male Beneficiaries |
353 |
Number Of Non Hispanic White Beneficiaries |
595 |
Number Of Black or African American Beneficiaries |
85 |
Number Of AsianPacific Islander Beneficiaries |
100 |
Number Of Hispanic Beneficiaries |
98 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
669 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
229 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.764 |