National Provider Identifier [NPI]: |
1578504817 |
Last Name Of The Provider |
JAIN |
First Name Of The Provider |
SANJAY |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4402 CHURCHMAN AVE STE 408 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402153102 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
2718 |
Number Of Medicare Beneficiaries |
875 |
Total Submitted Charge Amount |
763916 |
Total Medicare Allowed Amount |
329300.05 |
Total Medicare Payment Amount |
257105.34 |
Total Medicare Standardized Payment Amount |
272513.2 |
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 |
50 |
Number Of Medical Services |
2718 |
Number Of Medicare Beneficiaries With Medical Services |
875 |
Total Medical Submitted Charge Amount |
763916 |
Total Medical Medicare Allowed Amount |
329300.05 |
Total Medical Medicare Payment Amount |
257105.34 |
Total Medical Medicare Standardized Payment Amount |
272513.2 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
243 |
Number Of Beneficiaries Age 65 to 74 |
344 |
Number Of Beneficiaries Age 75 to 84 |
195 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
576 |
Number Of Male Beneficiaries |
299 |
Number Of Non Hispanic White Beneficiaries |
734 |
Number Of Black or African American Beneficiaries |
114 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
588 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
287 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6204 |