National Provider Identifier [NPI]: |
1558326207 |
Last Name Of The Provider |
KHURANA |
First Name Of The Provider |
SANDEEP |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MBBS |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1120 15TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309120004 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
302 |
Number Of Medicare Beneficiaries |
154 |
Total Submitted Charge Amount |
99784 |
Total Medicare Allowed Amount |
32334.45 |
Total Medicare Payment Amount |
25341.33 |
Total Medicare Standardized Payment Amount |
26237.94 |
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 |
23 |
Number Of Medical Services |
302 |
Number Of Medicare Beneficiaries With Medical Services |
154 |
Total Medical Submitted Charge Amount |
99784 |
Total Medical Medicare Allowed Amount |
32334.45 |
Total Medical Medicare Payment Amount |
25341.33 |
Total Medical Medicare Standardized Payment Amount |
26237.94 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
79 |
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 |
80 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.5718 |