National Provider Identifier [NPI]: |
1205818085 |
Last Name Of The Provider |
KANDULA |
First Name Of The Provider |
ARUNA |
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 |
1501 S CALIFORNIA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606081732 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
1905 |
Number Of Medicare Beneficiaries |
243 |
Total Submitted Charge Amount |
189753 |
Total Medicare Allowed Amount |
106157.84 |
Total Medicare Payment Amount |
78194.24 |
Total Medicare Standardized Payment Amount |
75496.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
21 |
Number Of Drug Services |
203 |
Number Of Medicare Beneficiaries With Drug Services |
92 |
Total Drug Submitted ChargeAmount |
4748 |
Total Drug Medicare AllowedAmount |
2536.35 |
Total Drug Medicare PaymentAmount |
2379.98 |
Total Drug Medicare Standardized Payment Amount |
2379.98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
57 |
Number Of Medical Services |
1702 |
Number Of Medicare Beneficiaries With Medical Services |
243 |
Total Medical Submitted Charge Amount |
185005 |
Total Medical Medicare Allowed Amount |
103621.49 |
Total Medical Medicare Payment Amount |
75814.26 |
Total Medical Medicare Standardized Payment Amount |
73116.93 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2915 |