National Provider Identifier [NPI]: |
1235210360 |
Last Name Of The Provider |
PAI |
First Name Of The Provider |
ANIL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6701 ROCKSIDE RD |
Street Address 2 Of The Provider |
#370 |
City Of The Provider |
INDEPENDENCE |
Zip Code Of The Provider |
441312358 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
2155 |
Number Of Medicare Beneficiaries |
605 |
Total Submitted Charge Amount |
339778 |
Total Medicare Allowed Amount |
185963.89 |
Total Medicare Payment Amount |
138034.23 |
Total Medicare Standardized Payment Amount |
141060.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
612 |
Total Drug Medicare AllowedAmount |
282.04 |
Total Drug Medicare PaymentAmount |
276.42 |
Total Drug Medicare Standardized Payment Amount |
276.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
2131 |
Number Of Medicare Beneficiaries With Medical Services |
605 |
Total Medical Submitted Charge Amount |
339166 |
Total Medical Medicare Allowed Amount |
185681.85 |
Total Medical Medicare Payment Amount |
137757.81 |
Total Medical Medicare Standardized Payment Amount |
140784.23 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
129 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
163 |
Number Of Beneficiaries Age Greater 84 |
153 |
Number Of Female Beneficiaries |
345 |
Number Of Male Beneficiaries |
260 |
Number Of Non Hispanic White Beneficiaries |
357 |
Number Of Black or African American Beneficiaries |
227 |
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 |
371 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
234 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9092 |