National Provider Identifier [NPI]: |
1669747374 |
Last Name Of The Provider |
KAILASH |
First Name Of The Provider |
KAILASH |
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 |
1350 WALTON WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309012612 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1801 |
Number Of Medicare Beneficiaries |
765 |
Total Submitted Charge Amount |
424022 |
Total Medicare Allowed Amount |
173244.65 |
Total Medicare Payment Amount |
135102.79 |
Total Medicare Standardized Payment Amount |
140142.09 |
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 |
18 |
Number Of Medical Services |
1801 |
Number Of Medicare Beneficiaries With Medical Services |
765 |
Total Medical Submitted Charge Amount |
424022 |
Total Medical Medicare Allowed Amount |
173244.65 |
Total Medical Medicare Payment Amount |
135102.79 |
Total Medical Medicare Standardized Payment Amount |
140142.09 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
223 |
Number Of Beneficiaries Age 75 to 84 |
249 |
Number Of Beneficiaries Age Greater 84 |
178 |
Number Of Female Beneficiaries |
426 |
Number Of Male Beneficiaries |
339 |
Number Of Non Hispanic White Beneficiaries |
555 |
Number Of Black or African American Beneficiaries |
194 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
541 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
224 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.2569 |