National Provider Identifier [NPI]: |
1154597409 |
Last Name Of The Provider |
TADIKONDA |
First Name Of The Provider |
SANDHYA |
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 |
1236 E ELIZABETH ST |
Street Address 2 Of The Provider |
SUITE 3 |
City Of The Provider |
FORT COLLINS |
Zip Code Of The Provider |
805244000 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1232 |
Number Of Medicare Beneficiaries |
499 |
Total Submitted Charge Amount |
244439.44 |
Total Medicare Allowed Amount |
132335.02 |
Total Medicare Payment Amount |
101645.15 |
Total Medicare Standardized Payment Amount |
102605.6 |
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 |
14 |
Number Of Medical Services |
1232 |
Number Of Medicare Beneficiaries With Medical Services |
499 |
Total Medical Submitted Charge Amount |
244439.44 |
Total Medical Medicare Allowed Amount |
132335.02 |
Total Medical Medicare Payment Amount |
101645.15 |
Total Medical Medicare Standardized Payment Amount |
102605.6 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
167 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
281 |
Number Of Male Beneficiaries |
218 |
Number Of Non Hispanic White Beneficiaries |
461 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
393 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.1858 |