National Provider Identifier [NPI]: |
1386835437 |
Last Name Of The Provider |
SUS |
First Name Of The Provider |
RACHANA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4720 S I 10 SERVICE RD W |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
METAIRIE |
Zip Code Of The Provider |
700017404 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
181 |
Number Of Medicare Beneficiaries |
109 |
Total Submitted Charge Amount |
25421 |
Total Medicare Allowed Amount |
14345.99 |
Total Medicare Payment Amount |
10566.6 |
Total Medicare Standardized Payment Amount |
10698.73 |
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 |
13 |
Number Of Medical Services |
181 |
Number Of Medicare Beneficiaries With Medical Services |
109 |
Total Medical Submitted Charge Amount |
25421 |
Total Medical Medicare Allowed Amount |
14345.99 |
Total Medical Medicare Payment Amount |
10566.6 |
Total Medical Medicare Standardized Payment Amount |
10698.73 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
64 |
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 |
72 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3032 |