National Provider Identifier [NPI]: |
1093800104 |
Last Name Of The Provider |
BOTTA |
First Name Of The Provider |
ESWARA |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3601 TVC |
Street Address 2 Of The Provider |
|
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372320001 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
248 |
Number Of Medicare Beneficiaries |
194 |
Total Submitted Charge Amount |
421625 |
Total Medicare Allowed Amount |
44332.01 |
Total Medicare Payment Amount |
34041.95 |
Total Medicare Standardized Payment Amount |
36766.25 |
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 |
69 |
Number Of Medical Services |
248 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
421625 |
Total Medical Medicare Allowed Amount |
44332.01 |
Total Medical Medicare Payment Amount |
34041.95 |
Total Medical Medicare Standardized Payment Amount |
36766.25 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
78 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
177 |
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 |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.8906 |