National Provider Identifier [NPI]: |
1306852066 |
Last Name Of The Provider |
MEESALA |
First Name Of The Provider |
SANDHYA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1590 W ALGONQUIN RD |
Street Address 2 Of The Provider |
167 |
City Of The Provider |
HOFFMAN ESTATES |
Zip Code Of The Provider |
601921575 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
1519 |
Number Of Medicare Beneficiaries |
267 |
Total Submitted Charge Amount |
272815 |
Total Medicare Allowed Amount |
162518.75 |
Total Medicare Payment Amount |
125281.58 |
Total Medicare Standardized Payment Amount |
127504.92 |
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 |
9 |
Number Of Medical Services |
1519 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
272815 |
Total Medical Medicare Allowed Amount |
162518.75 |
Total Medical Medicare Payment Amount |
125281.58 |
Total Medical Medicare Standardized Payment Amount |
127504.92 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
252 |
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 |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
1.6507 |