National Provider Identifier [NPI]: |
1235137266 |
Last Name Of The Provider |
CHILUKURI |
First Name Of The Provider |
SYAM |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
801 SAINT MARYS DR |
Street Address 2 Of The Provider |
SUITE 205W & 300W |
City Of The Provider |
EVANSVILLE |
Zip Code Of The Provider |
477140560 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Colorectal Surgery (formerly proctology) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
100 |
Number Of Services |
769 |
Number Of Medicare Beneficiaries |
442 |
Total Submitted Charge Amount |
613686 |
Total Medicare Allowed Amount |
159144.72 |
Total Medicare Payment Amount |
126702.33 |
Total Medicare Standardized Payment Amount |
134845.94 |
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 |
100 |
Number Of Medical Services |
769 |
Number Of Medicare Beneficiaries With Medical Services |
442 |
Total Medical Submitted Charge Amount |
613686 |
Total Medical Medicare Allowed Amount |
159144.72 |
Total Medical Medicare Payment Amount |
126702.33 |
Total Medical Medicare Standardized Payment Amount |
134845.94 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
252 |
Number Of Male Beneficiaries |
190 |
Number Of Non Hispanic White Beneficiaries |
423 |
Number Of Black or African American Beneficiaries |
|
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 |
369 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1723 |