National Provider Identifier [NPI]: |
1336173475 |
Last Name Of The Provider |
GANARAJ |
First Name Of The Provider |
ARCHANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8160 WALNUT HILL LN |
Street Address 2 Of The Provider |
SUITE 113 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752314339 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
577 |
Number Of Medicare Beneficiaries |
348 |
Total Submitted Charge Amount |
180013 |
Total Medicare Allowed Amount |
75160.38 |
Total Medicare Payment Amount |
53157.78 |
Total Medicare Standardized Payment Amount |
53708.17 |
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 |
19 |
Number Of Medical Services |
577 |
Number Of Medicare Beneficiaries With Medical Services |
348 |
Total Medical Submitted Charge Amount |
180013 |
Total Medical Medicare Allowed Amount |
75160.38 |
Total Medical Medicare Payment Amount |
53157.78 |
Total Medical Medicare Standardized Payment Amount |
53708.17 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
198 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
321 |
Number Of Black or African American Beneficiaries |
16 |
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 |
337 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
73 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
7 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9011 |