National Provider Identifier [NPI]: |
1457794422 |
Last Name Of The Provider |
DASARI |
First Name Of The Provider |
NARESH |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
333 BUDLONG RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CRANSTON |
Zip Code Of The Provider |
029206337 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
727 |
Number Of Medicare Beneficiaries |
206 |
Total Submitted Charge Amount |
118205 |
Total Medicare Allowed Amount |
78479.42 |
Total Medicare Payment Amount |
61505.57 |
Total Medicare Standardized Payment Amount |
58973.62 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
72 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
115 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
144 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
19 |
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 |
37 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
169 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
50 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
33 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.1932 |