National Provider Identifier [NPI]: |
1063544047 |
Last Name Of The Provider |
GOWDA |
First Name Of The Provider |
NAVEEN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
420 DELAWARE ST SE |
Street Address 2 Of The Provider |
ROOM B-211 MAYO, MMC 292 |
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554550341 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
194 |
Number Of Services |
1754 |
Number Of Medicare Beneficiaries |
996 |
Total Submitted Charge Amount |
323980 |
Total Medicare Allowed Amount |
102234.46 |
Total Medicare Payment Amount |
79588.94 |
Total Medicare Standardized Payment Amount |
83524.5 |
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 |
194 |
Number Of Medical Services |
1754 |
Number Of Medicare Beneficiaries With Medical Services |
996 |
Total Medical Submitted Charge Amount |
323980 |
Total Medical Medicare Allowed Amount |
102234.46 |
Total Medical Medicare Payment Amount |
79588.94 |
Total Medical Medicare Standardized Payment Amount |
83524.5 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
169 |
Number Of Beneficiaries Age 65 to 74 |
342 |
Number Of Beneficiaries Age 75 to 84 |
334 |
Number Of Beneficiaries Age Greater 84 |
151 |
Number Of Female Beneficiaries |
479 |
Number Of Male Beneficiaries |
517 |
Number Of Non Hispanic White Beneficiaries |
954 |
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 |
779 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
217 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6496 |