National Provider Identifier [NPI]: |
1437109493 |
Last Name Of The Provider |
KHANT |
First Name Of The Provider |
SANJAY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3903 S COBB DR SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SMYRNA |
Zip Code Of The Provider |
300806342 |
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 |
38 |
Number Of Services |
922 |
Number Of Medicare Beneficiaries |
313 |
Total Submitted Charge Amount |
184080 |
Total Medicare Allowed Amount |
65703.19 |
Total Medicare Payment Amount |
48688.89 |
Total Medicare Standardized Payment Amount |
49506.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
120 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
9717 |
Total Drug Medicare AllowedAmount |
2637.85 |
Total Drug Medicare PaymentAmount |
2370.4 |
Total Drug Medicare Standardized Payment Amount |
2370.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
802 |
Number Of Medicare Beneficiaries With Medical Services |
313 |
Total Medical Submitted Charge Amount |
174363 |
Total Medical Medicare Allowed Amount |
63065.34 |
Total Medical Medicare Payment Amount |
46318.49 |
Total Medical Medicare Standardized Payment Amount |
47136.07 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
153 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
227 |
Number Of Black or African American Beneficiaries |
61 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
274 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9898 |