National Provider Identifier [NPI]: |
1700084191 |
Last Name Of The Provider |
RENGANATHAN |
First Name Of The Provider |
USHA |
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 |
1791 HIGHWAY 64 E |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANAMOSA |
Zip Code Of The Provider |
522052112 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1458 |
Number Of Medicare Beneficiaries |
511 |
Total Submitted Charge Amount |
475684 |
Total Medicare Allowed Amount |
150535.17 |
Total Medicare Payment Amount |
115242.54 |
Total Medicare Standardized Payment Amount |
124792.99 |
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 |
19 |
Number Of Medical Services |
1458 |
Number Of Medicare Beneficiaries With Medical Services |
511 |
Total Medical Submitted Charge Amount |
475684 |
Total Medical Medicare Allowed Amount |
150535.17 |
Total Medical Medicare Payment Amount |
115242.54 |
Total Medical Medicare Standardized Payment Amount |
124792.99 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
139 |
Number Of Female Beneficiaries |
317 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
493 |
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 |
363 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
148 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8299 |