National Provider Identifier [NPI]: |
1558482075 |
Last Name Of The Provider |
SIDANA |
First Name Of The Provider |
JASDEEP |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
849 BOSTON POST RD |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
MILFORD |
Zip Code Of The Provider |
064603537 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
11226 |
Number Of Medicare Beneficiaries |
642 |
Total Submitted Charge Amount |
1694834.28 |
Total Medicare Allowed Amount |
759282.65 |
Total Medicare Payment Amount |
590704.89 |
Total Medicare Standardized Payment Amount |
547379.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
4052 |
Number Of Medicare Beneficiaries With Drug Services |
78 |
Total Drug Submitted ChargeAmount |
104170 |
Total Drug Medicare AllowedAmount |
102393.27 |
Total Drug Medicare PaymentAmount |
80581.7 |
Total Drug Medicare Standardized Payment Amount |
80581.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
7174 |
Number Of Medicare Beneficiaries With Medical Services |
642 |
Total Medical Submitted Charge Amount |
1590664.28 |
Total Medical Medicare Allowed Amount |
656889.38 |
Total Medical Medicare Payment Amount |
510123.19 |
Total Medical Medicare Standardized Payment Amount |
466798.02 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
189 |
Number Of Beneficiaries Age 75 to 84 |
218 |
Number Of Beneficiaries Age Greater 84 |
137 |
Number Of Female Beneficiaries |
380 |
Number Of Male Beneficiaries |
262 |
Number Of Non Hispanic White Beneficiaries |
565 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
414 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
228 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
73 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.0798 |