National Provider Identifier [NPI]: |
1053491910 |
Last Name Of The Provider |
RENGARAJAN |
First Name Of The Provider |
USHS |
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 |
75 N COUNTRY RD |
Street Address 2 Of The Provider |
JOHN T MATHER MEMORIAL HOSPITAL |
City Of The Provider |
PORT JEFFERSON |
Zip Code Of The Provider |
117772119 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1253 |
Number Of Medicare Beneficiaries |
1111 |
Total Submitted Charge Amount |
1051220 |
Total Medicare Allowed Amount |
188383.64 |
Total Medicare Payment Amount |
146285.63 |
Total Medicare Standardized Payment Amount |
130285.21 |
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 |
21 |
Number Of Medical Services |
1253 |
Number Of Medicare Beneficiaries With Medical Services |
1111 |
Total Medical Submitted Charge Amount |
1051220 |
Total Medical Medicare Allowed Amount |
188383.64 |
Total Medical Medicare Payment Amount |
146285.63 |
Total Medical Medicare Standardized Payment Amount |
130285.21 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
247 |
Number Of Beneficiaries Age 65 to 74 |
312 |
Number Of Beneficiaries Age 75 to 84 |
279 |
Number Of Beneficiaries Age Greater 84 |
273 |
Number Of Female Beneficiaries |
681 |
Number Of Male Beneficiaries |
430 |
Number Of Non Hispanic White Beneficiaries |
995 |
Number Of Black or African American Beneficiaries |
48 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
42 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
764 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
347 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.0155 |