National Provider Identifier [NPI]: |
1538125760 |
Last Name Of The Provider |
MACHANDA |
First Name Of The Provider |
SEAN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1215 RIDGEWOOD DR |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
BOWLING GREEN |
Zip Code Of The Provider |
434022690 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
1481 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
104566 |
Total Medicare Allowed Amount |
69480.14 |
Total Medicare Payment Amount |
48412.84 |
Total Medicare Standardized Payment Amount |
50639.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
89 |
Number Of Medicare Beneficiaries With Drug Services |
68 |
Total Drug Submitted ChargeAmount |
3195 |
Total Drug Medicare AllowedAmount |
2507.38 |
Total Drug Medicare PaymentAmount |
2419.48 |
Total Drug Medicare Standardized Payment Amount |
2419.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1392 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
101371 |
Total Medical Medicare Allowed Amount |
66972.76 |
Total Medical Medicare Payment Amount |
45993.36 |
Total Medical Medicare Standardized Payment Amount |
48220.22 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
170 |
Number Of Male Beneficiaries |
98 |
Number Of Non Hispanic White Beneficiaries |
250 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
224 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0368 |