National Provider Identifier [NPI]: |
1578687331 |
Last Name Of The Provider |
GUNTUR |
First Name Of The Provider |
VAMSI |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1101 HOSPITAL DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBIA |
Zip Code Of The Provider |
65212 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1139 |
Number Of Medicare Beneficiaries |
466 |
Total Submitted Charge Amount |
210429 |
Total Medicare Allowed Amount |
67318.35 |
Total Medicare Payment Amount |
51575.24 |
Total Medicare Standardized Payment Amount |
53948.58 |
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 |
39 |
Number Of Medical Services |
1139 |
Number Of Medicare Beneficiaries With Medical Services |
466 |
Total Medical Submitted Charge Amount |
210429 |
Total Medical Medicare Allowed Amount |
67318.35 |
Total Medical Medicare Payment Amount |
51575.24 |
Total Medical Medicare Standardized Payment Amount |
53948.58 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
117 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
265 |
Number Of Male Beneficiaries |
201 |
Number Of Non Hispanic White Beneficiaries |
426 |
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 |
307 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
159 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
24 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
63 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.0602 |