National Provider Identifier [NPI]: |
1710128046 |
Last Name Of The Provider |
THAKALLAPALI |
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 |
319 W LANDIS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
VINELAND |
Zip Code Of The Provider |
083608101 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
648 |
Number Of Medicare Beneficiaries |
503 |
Total Submitted Charge Amount |
225480 |
Total Medicare Allowed Amount |
97285.28 |
Total Medicare Payment Amount |
75595.82 |
Total Medicare Standardized Payment Amount |
74578.4 |
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 |
20 |
Number Of Medical Services |
648 |
Number Of Medicare Beneficiaries With Medical Services |
503 |
Total Medical Submitted Charge Amount |
225480 |
Total Medical Medicare Allowed Amount |
97285.28 |
Total Medical Medicare Payment Amount |
75595.82 |
Total Medical Medicare Standardized Payment Amount |
74578.4 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
140 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
134 |
Number Of Female Beneficiaries |
288 |
Number Of Male Beneficiaries |
215 |
Number Of Non Hispanic White Beneficiaries |
453 |
Number Of Black or African American Beneficiaries |
36 |
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 |
397 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
1.896 |