National Provider Identifier [NPI]: |
1730154329 |
Last Name Of The Provider |
ELANGOVAN |
First Name Of The Provider |
SUDHA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1909 214TH ST SE |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
BOTHELL |
Zip Code Of The Provider |
980214412 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
202 |
Number Of Medicare Beneficiaries |
141 |
Total Submitted Charge Amount |
59816 |
Total Medicare Allowed Amount |
21532.05 |
Total Medicare Payment Amount |
16046.04 |
Total Medicare Standardized Payment Amount |
14805.32 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
96 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
14 |
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 |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
1.2096 |