National Provider Identifier [NPI]: |
1760696199 |
Last Name Of The Provider |
NANDA |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3301 W GANDY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336112931 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
529 |
Number Of Medicare Beneficiaries |
281 |
Total Submitted Charge Amount |
68802.08 |
Total Medicare Allowed Amount |
35711.52 |
Total Medicare Payment Amount |
24416.53 |
Total Medicare Standardized Payment Amount |
24499.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
458 |
Total Drug Medicare AllowedAmount |
282.74 |
Total Drug Medicare PaymentAmount |
221.65 |
Total Drug Medicare Standardized Payment Amount |
221.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
507 |
Number Of Medicare Beneficiaries With Medical Services |
281 |
Total Medical Submitted Charge Amount |
68344.08 |
Total Medical Medicare Allowed Amount |
35428.78 |
Total Medical Medicare Payment Amount |
24194.88 |
Total Medical Medicare Standardized Payment Amount |
24277.97 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
242 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
266 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0073 |