National Provider Identifier [NPI]: |
1033179189 |
Last Name Of The Provider |
YADAVALLI |
First Name Of The Provider |
SAILAJA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3601 W 13 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROYAL OAK |
Zip Code Of The Provider |
48073 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
126 |
Number Of Services |
2185 |
Number Of Medicare Beneficiaries |
1548 |
Total Submitted Charge Amount |
116665 |
Total Medicare Allowed Amount |
64058.97 |
Total Medicare Payment Amount |
47405.5 |
Total Medicare Standardized Payment Amount |
46089.64 |
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 |
126 |
Number Of Medical Services |
2185 |
Number Of Medicare Beneficiaries With Medical Services |
1548 |
Total Medical Submitted Charge Amount |
116665 |
Total Medical Medicare Allowed Amount |
64058.97 |
Total Medical Medicare Payment Amount |
47405.5 |
Total Medical Medicare Standardized Payment Amount |
46089.64 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
239 |
Number Of Beneficiaries Age 65 to 74 |
538 |
Number Of Beneficiaries Age 75 to 84 |
478 |
Number Of Beneficiaries Age Greater 84 |
293 |
Number Of Female Beneficiaries |
959 |
Number Of Male Beneficiaries |
589 |
Number Of Non Hispanic White Beneficiaries |
1233 |
Number Of Black or African American Beneficiaries |
239 |
Number Of AsianPacific Islander Beneficiaries |
20 |
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
1266 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
282 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7774 |