National Provider Identifier [NPI]: |
1215191770 |
Last Name Of The Provider |
MIKKILINENI |
First Name Of The Provider |
HIMA |
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 |
2111 SW 20TH PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
OCALA |
Zip Code Of The Provider |
344717734 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
8348 |
Number Of Medicare Beneficiaries |
1393 |
Total Submitted Charge Amount |
2361769.46 |
Total Medicare Allowed Amount |
1151921.71 |
Total Medicare Payment Amount |
882239.46 |
Total Medicare Standardized Payment Amount |
895253.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
698 |
Number Of Medicare Beneficiaries With Drug Services |
179 |
Total Drug Submitted ChargeAmount |
69353.44 |
Total Drug Medicare AllowedAmount |
34957.89 |
Total Drug Medicare PaymentAmount |
27240.51 |
Total Drug Medicare Standardized Payment Amount |
27240.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
7650 |
Number Of Medicare Beneficiaries With Medical Services |
1393 |
Total Medical Submitted Charge Amount |
2292416.02 |
Total Medical Medicare Allowed Amount |
1116963.82 |
Total Medical Medicare Payment Amount |
854998.95 |
Total Medical Medicare Standardized Payment Amount |
868012.53 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
520 |
Number Of Beneficiaries Age 75 to 84 |
502 |
Number Of Beneficiaries Age Greater 84 |
235 |
Number Of Female Beneficiaries |
755 |
Number Of Male Beneficiaries |
638 |
Number Of Non Hispanic White Beneficiaries |
1242 |
Number Of Black or African American Beneficiaries |
86 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
43 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
252 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.7547 |