National Provider Identifier [NPI]: |
1700842986 |
Last Name Of The Provider |
JULKA |
First Name Of The Provider |
MANJULA |
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 |
1175 DIANE CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEWISVILLE |
Zip Code Of The Provider |
750674397 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
297 |
Number Of Medicare Beneficiaries |
130 |
Total Submitted Charge Amount |
58950 |
Total Medicare Allowed Amount |
23328.87 |
Total Medicare Payment Amount |
14871.39 |
Total Medicare Standardized Payment Amount |
15220.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1197 |
Total Drug Medicare AllowedAmount |
551 |
Total Drug Medicare PaymentAmount |
539.94 |
Total Drug Medicare Standardized Payment Amount |
539.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
280 |
Number Of Medicare Beneficiaries With Medical Services |
130 |
Total Medical Submitted Charge Amount |
57753 |
Total Medical Medicare Allowed Amount |
22777.87 |
Total Medical Medicare Payment Amount |
14331.45 |
Total Medical Medicare Standardized Payment Amount |
14680.12 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
57 |
Number Of Black or African American Beneficiaries |
55 |
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 |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
14 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2189 |