National Provider Identifier [NPI]: |
1891981304 |
Last Name Of The Provider |
SADASIVAN |
First Name Of The Provider |
SHEETHU |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1115 N RONALD REAGAN PKWY |
Street Address 2 Of The Provider |
STE 206 |
City Of The Provider |
AVON |
Zip Code Of The Provider |
461236911 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1360 |
Number Of Medicare Beneficiaries |
356 |
Total Submitted Charge Amount |
235672 |
Total Medicare Allowed Amount |
109496.16 |
Total Medicare Payment Amount |
84903.69 |
Total Medicare Standardized Payment Amount |
88932.87 |
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 |
15 |
Number Of Medical Services |
1360 |
Number Of Medicare Beneficiaries With Medical Services |
356 |
Total Medical Submitted Charge Amount |
235672 |
Total Medical Medicare Allowed Amount |
109496.16 |
Total Medical Medicare Payment Amount |
84903.69 |
Total Medical Medicare Standardized Payment Amount |
88932.87 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
234 |
Number Of Male Beneficiaries |
122 |
Number Of Non Hispanic White Beneficiaries |
339 |
Number Of Black or African American Beneficiaries |
|
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 |
246 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
57 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.059 |