National Provider Identifier [NPI]: |
1730356213 |
Last Name Of The Provider |
SANDRU |
First Name Of The Provider |
MIRELA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5301 S CONGRESS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTIS |
Zip Code Of The Provider |
334621149 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
835 |
Number Of Medicare Beneficiaries |
271 |
Total Submitted Charge Amount |
225465.9 |
Total Medicare Allowed Amount |
73879.34 |
Total Medicare Payment Amount |
55560.21 |
Total Medicare Standardized Payment Amount |
58938.6 |
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 |
15 |
Number Of Medical Services |
835 |
Number Of Medicare Beneficiaries With Medical Services |
271 |
Total Medical Submitted Charge Amount |
225465.9 |
Total Medical Medicare Allowed Amount |
73879.34 |
Total Medical Medicare Payment Amount |
55560.21 |
Total Medical Medicare Standardized Payment Amount |
58938.6 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
139 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
254 |
Number Of Black or African American Beneficiaries |
|
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 |
152 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.7208 |