National Provider Identifier [NPI]: |
1801836176 |
Last Name Of The Provider |
MOHAN |
First Name Of The Provider |
GOVINDARAJ |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
835 HOSPITAL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANA |
Zip Code Of The Provider |
157013629 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
153 |
Number Of Services |
6472 |
Number Of Medicare Beneficiaries |
1158 |
Total Submitted Charge Amount |
691375.3 |
Total Medicare Allowed Amount |
211592.66 |
Total Medicare Payment Amount |
161408.83 |
Total Medicare Standardized Payment Amount |
169979.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
4040 |
Number Of Medicare Beneficiaries With Drug Services |
95 |
Total Drug Submitted ChargeAmount |
36297.3 |
Total Drug Medicare AllowedAmount |
8498.93 |
Total Drug Medicare PaymentAmount |
6663.2 |
Total Drug Medicare Standardized Payment Amount |
6663.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
148 |
Number Of Medical Services |
2432 |
Number Of Medicare Beneficiaries With Medical Services |
1158 |
Total Medical Submitted Charge Amount |
655078 |
Total Medical Medicare Allowed Amount |
203093.73 |
Total Medical Medicare Payment Amount |
154745.63 |
Total Medical Medicare Standardized Payment Amount |
163316.03 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
243 |
Number Of Beneficiaries Age 65 to 74 |
418 |
Number Of Beneficiaries Age 75 to 84 |
291 |
Number Of Beneficiaries Age Greater 84 |
206 |
Number Of Female Beneficiaries |
637 |
Number Of Male Beneficiaries |
521 |
Number Of Non Hispanic White Beneficiaries |
1032 |
Number Of Black or African American Beneficiaries |
100 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
851 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
307 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.8893 |