National Provider Identifier [NPI]: |
1922200013 |
Last Name Of The Provider |
SANDERS |
First Name Of The Provider |
ALICIA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1701 S CREASY LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAFAYETTE |
Zip Code Of The Provider |
479054972 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
794 |
Number Of Medicare Beneficiaries |
634 |
Total Submitted Charge Amount |
939233 |
Total Medicare Allowed Amount |
109882.62 |
Total Medicare Payment Amount |
84592.04 |
Total Medicare Standardized Payment Amount |
87590.3 |
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 |
34 |
Number Of Medical Services |
794 |
Number Of Medicare Beneficiaries With Medical Services |
634 |
Total Medical Submitted Charge Amount |
939233 |
Total Medical Medicare Allowed Amount |
109882.62 |
Total Medical Medicare Payment Amount |
84592.04 |
Total Medical Medicare Standardized Payment Amount |
87590.3 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
164 |
Number Of Beneficiaries Age 65 to 74 |
184 |
Number Of Beneficiaries Age 75 to 84 |
155 |
Number Of Beneficiaries Age Greater 84 |
131 |
Number Of Female Beneficiaries |
374 |
Number Of Male Beneficiaries |
260 |
Number Of Non Hispanic White Beneficiaries |
611 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
405 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
229 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.8723 |