National Provider Identifier [NPI]: |
1811922198 |
Last Name Of The Provider |
KANTALA |
First Name Of The Provider |
ROOPESH |
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 |
6111 E ARBOR AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MESA |
Zip Code Of The Provider |
852066059 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
112 |
Number Of Services |
221840 |
Number Of Medicare Beneficiaries |
772 |
Total Submitted Charge Amount |
6448038 |
Total Medicare Allowed Amount |
3087152.74 |
Total Medicare Payment Amount |
2401056.14 |
Total Medicare Standardized Payment Amount |
2398727.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
62 |
Number Of Drug Services |
214674 |
Number Of Medicare Beneficiaries With Drug Services |
268 |
Total Drug Submitted ChargeAmount |
4626491 |
Total Drug Medicare AllowedAmount |
2253732.23 |
Total Drug Medicare PaymentAmount |
1761122.87 |
Total Drug Medicare Standardized Payment Amount |
1761122.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
7166 |
Number Of Medicare Beneficiaries With Medical Services |
772 |
Total Medical Submitted Charge Amount |
1821547 |
Total Medical Medicare Allowed Amount |
833420.51 |
Total Medical Medicare Payment Amount |
639933.27 |
Total Medical Medicare Standardized Payment Amount |
637604.86 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
315 |
Number Of Beneficiaries Age 75 to 84 |
289 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
394 |
Number Of Male Beneficiaries |
378 |
Number Of Non Hispanic White Beneficiaries |
665 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
55 |
Number Of American Indian Alaska Native Beneficiaries |
15 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
666 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
43 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.1137 |