National Provider Identifier [NPI]: |
1205149531 |
Last Name Of The Provider |
KILARU |
First Name Of The Provider |
ASHA |
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 |
8730 YOUREE DR |
Street Address 2 Of The Provider |
STE A |
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
711152500 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
503 |
Number Of Medicare Beneficiaries |
130 |
Total Submitted Charge Amount |
77148 |
Total Medicare Allowed Amount |
37359.3 |
Total Medicare Payment Amount |
28981.27 |
Total Medicare Standardized Payment Amount |
31338.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
69 |
Number Of Medicare Beneficiaries With Drug Services |
62 |
Total Drug Submitted ChargeAmount |
2240 |
Total Drug Medicare AllowedAmount |
1692.61 |
Total Drug Medicare PaymentAmount |
1563.14 |
Total Drug Medicare Standardized Payment Amount |
1563.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
434 |
Number Of Medicare Beneficiaries With Medical Services |
130 |
Total Medical Submitted Charge Amount |
74908 |
Total Medical Medicare Allowed Amount |
35666.69 |
Total Medical Medicare Payment Amount |
27418.13 |
Total Medical Medicare Standardized Payment Amount |
29775.38 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
72 |
Number Of Black or African American Beneficiaries |
58 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5183 |