National Provider Identifier [NPI]: |
1538153549 |
Last Name Of The Provider |
KOKA |
First Name Of The Provider |
ANURADHA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
916 SYCAMORE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
VISTA |
Zip Code Of The Provider |
920817815 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
2741 |
Number Of Medicare Beneficiaries |
168 |
Total Submitted Charge Amount |
1463824.85 |
Total Medicare Allowed Amount |
816170 |
Total Medicare Payment Amount |
637780.22 |
Total Medicare Standardized Payment Amount |
608891.12 |
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 |
40 |
Number Of Medical Services |
2741 |
Number Of Medicare Beneficiaries With Medical Services |
168 |
Total Medical Submitted Charge Amount |
1463824.85 |
Total Medical Medicare Allowed Amount |
816170 |
Total Medical Medicare Payment Amount |
637780.22 |
Total Medical Medicare Standardized Payment Amount |
608891.12 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
130 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
141 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
146 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
65 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6003 |