National Provider Identifier [NPI]: |
1295932754 |
Last Name Of The Provider |
KISHORE |
First Name Of The Provider |
REKHA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1250 E MARSHALL ST |
Street Address 2 Of The Provider |
RADIOLOGY |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232985051 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
1333 |
Number Of Medicare Beneficiaries |
1010 |
Total Submitted Charge Amount |
231040 |
Total Medicare Allowed Amount |
57389.85 |
Total Medicare Payment Amount |
41529.41 |
Total Medicare Standardized Payment Amount |
44530.79 |
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 |
55 |
Number Of Medical Services |
1333 |
Number Of Medicare Beneficiaries With Medical Services |
1010 |
Total Medical Submitted Charge Amount |
231040 |
Total Medical Medicare Allowed Amount |
57389.85 |
Total Medical Medicare Payment Amount |
41529.41 |
Total Medical Medicare Standardized Payment Amount |
44530.79 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
369 |
Number Of Beneficiaries Age 65 to 74 |
372 |
Number Of Beneficiaries Age 75 to 84 |
205 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
506 |
Number Of Male Beneficiaries |
504 |
Number Of Non Hispanic White Beneficiaries |
544 |
Number Of Black or African American Beneficiaries |
431 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
636 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
374 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.6836 |