National Provider Identifier [NPI]: |
1043246689 |
Last Name Of The Provider |
NAGAPPAN |
First Name Of The Provider |
POOMBAVAI |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12442 SW SCHOLLS FERRY RD |
Street Address 2 Of The Provider |
SUITE 106 |
City Of The Provider |
TIGARD |
Zip Code Of The Provider |
972233396 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
547 |
Number Of Medicare Beneficiaries |
173 |
Total Submitted Charge Amount |
157108 |
Total Medicare Allowed Amount |
51222.62 |
Total Medicare Payment Amount |
35197.79 |
Total Medicare Standardized Payment Amount |
34930.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
998 |
Total Drug Medicare AllowedAmount |
559.04 |
Total Drug Medicare PaymentAmount |
547.46 |
Total Drug Medicare Standardized Payment Amount |
547.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
506 |
Number Of Medicare Beneficiaries With Medical Services |
173 |
Total Medical Submitted Charge Amount |
156110 |
Total Medical Medicare Allowed Amount |
50663.58 |
Total Medical Medicare Payment Amount |
34650.33 |
Total Medical Medicare Standardized Payment Amount |
34383.51 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
136 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
22 |
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 |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9246 |