National Provider Identifier [NPI]: |
1841302403 |
Last Name Of The Provider |
PILLY |
First Name Of The Provider |
VIKAS |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7900 W JEFFERSON BLVD |
Street Address 2 Of The Provider |
SUITE 304 |
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468044128 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
9061 |
Number Of Medicare Beneficiaries |
1209 |
Total Submitted Charge Amount |
1310200.27 |
Total Medicare Allowed Amount |
424343.77 |
Total Medicare Payment Amount |
360016.87 |
Total Medicare Standardized Payment Amount |
336477.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
127 |
Number Of Medicare Beneficiaries With Drug Services |
49 |
Total Drug Submitted ChargeAmount |
2455 |
Total Drug Medicare AllowedAmount |
385.69 |
Total Drug Medicare PaymentAmount |
302.3 |
Total Drug Medicare Standardized Payment Amount |
302.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
86 |
Number Of Medical Services |
8934 |
Number Of Medicare Beneficiaries With Medical Services |
1209 |
Total Medical Submitted Charge Amount |
1307745.27 |
Total Medical Medicare Allowed Amount |
423958.08 |
Total Medical Medicare Payment Amount |
359714.57 |
Total Medical Medicare Standardized Payment Amount |
336175.17 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
896 |
Number Of Beneficiaries Age 65 to 74 |
248 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
636 |
Number Of Male Beneficiaries |
573 |
Number Of Non Hispanic White Beneficiaries |
1098 |
Number Of Black or African American Beneficiaries |
89 |
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 |
408 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
801 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.2822 |