National Provider Identifier [NPI]: |
1629085816 |
Last Name Of The Provider |
RAIKER |
First Name Of The Provider |
SMITA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9038 COLUMBIA AVE |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
MUNSTER |
Zip Code Of The Provider |
463212905 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1008 |
Number Of Medicare Beneficiaries |
201 |
Total Submitted Charge Amount |
200865 |
Total Medicare Allowed Amount |
80715.47 |
Total Medicare Payment Amount |
56146.31 |
Total Medicare Standardized Payment Amount |
57966.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
21 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
687 |
Total Drug Medicare AllowedAmount |
161.7 |
Total Drug Medicare PaymentAmount |
157.06 |
Total Drug Medicare Standardized Payment Amount |
157.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
987 |
Number Of Medicare Beneficiaries With Medical Services |
201 |
Total Medical Submitted Charge Amount |
200178 |
Total Medical Medicare Allowed Amount |
80553.77 |
Total Medical Medicare Payment Amount |
55989.25 |
Total Medical Medicare Standardized Payment Amount |
57809.12 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
164 |
Number Of Black or African American Beneficiaries |
20 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
|
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.3791 |