National Provider Identifier [NPI]: |
1770680688 |
Last Name Of The Provider |
SETHURAMAN |
First Name Of The Provider |
KINJAL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD, |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22 SOUTH GREENE STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212011544 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
413 |
Number Of Medicare Beneficiaries |
276 |
Total Submitted Charge Amount |
196754.46 |
Total Medicare Allowed Amount |
53673.69 |
Total Medicare Payment Amount |
40700.34 |
Total Medicare Standardized Payment Amount |
39078.59 |
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 |
16 |
Number Of Medical Services |
413 |
Number Of Medicare Beneficiaries With Medical Services |
276 |
Total Medical Submitted Charge Amount |
196754.46 |
Total Medical Medicare Allowed Amount |
53673.69 |
Total Medical Medicare Payment Amount |
40700.34 |
Total Medical Medicare Standardized Payment Amount |
39078.59 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
112 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
162 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
184 |
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 |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.3272 |