National Provider Identifier [NPI]: |
1487607180 |
Last Name Of The Provider |
SYMINGTON |
First Name Of The Provider |
BANU |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
725 POLE LINE RD W |
Street Address 2 Of The Provider |
|
City Of The Provider |
TWIN FALLS |
Zip Code Of The Provider |
833015800 |
State Code Of The Provider |
ID |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1192 |
Number Of Medicare Beneficiaries |
316 |
Total Submitted Charge Amount |
88069 |
Total Medicare Allowed Amount |
83054.82 |
Total Medicare Payment Amount |
58884.02 |
Total Medicare Standardized Payment Amount |
63371.81 |
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 |
15 |
Number Of Medical Services |
1192 |
Number Of Medicare Beneficiaries With Medical Services |
316 |
Total Medical Submitted Charge Amount |
88069 |
Total Medical Medicare Allowed Amount |
83054.82 |
Total Medical Medicare Payment Amount |
58884.02 |
Total Medical Medicare Standardized Payment Amount |
63371.81 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
205 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
302 |
Number Of Black or African American Beneficiaries |
0 |
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 |
270 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
49 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8092 |