National Provider Identifier [NPI]: |
1255597589 |
Last Name Of The Provider |
SREEDHARALA |
First Name Of The Provider |
VAMSI |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 S BALLENGER HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
FLINT |
Zip Code Of The Provider |
485323638 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1847 |
Number Of Medicare Beneficiaries |
705 |
Total Submitted Charge Amount |
282540.43 |
Total Medicare Allowed Amount |
185226.01 |
Total Medicare Payment Amount |
139922.18 |
Total Medicare Standardized Payment Amount |
143586.71 |
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 |
1847 |
Number Of Medicare Beneficiaries With Medical Services |
705 |
Total Medical Submitted Charge Amount |
282540.43 |
Total Medical Medicare Allowed Amount |
185226.01 |
Total Medical Medicare Payment Amount |
139922.18 |
Total Medical Medicare Standardized Payment Amount |
143586.71 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
169 |
Number Of Beneficiaries Age 65 to 74 |
193 |
Number Of Beneficiaries Age 75 to 84 |
181 |
Number Of Beneficiaries Age Greater 84 |
162 |
Number Of Female Beneficiaries |
390 |
Number Of Male Beneficiaries |
315 |
Number Of Non Hispanic White Beneficiaries |
491 |
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 |
356 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
349 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.4701 |