National Provider Identifier [NPI]: |
1619034964 |
Last Name Of The Provider |
CHERIYAN |
First Name Of The Provider |
ABRAHAM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
206 GASLIGHT BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LUFKIN |
Zip Code Of The Provider |
75904 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
3781 |
Number Of Medicare Beneficiaries |
962 |
Total Submitted Charge Amount |
927225 |
Total Medicare Allowed Amount |
382667.52 |
Total Medicare Payment Amount |
286287.2 |
Total Medicare Standardized Payment Amount |
303000.87 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
177 |
Number Of Beneficiaries Age 65 to 74 |
368 |
Number Of Beneficiaries Age 75 to 84 |
298 |
Number Of Beneficiaries Age Greater 84 |
119 |
Number Of Female Beneficiaries |
474 |
Number Of Male Beneficiaries |
488 |
Number Of Non Hispanic White Beneficiaries |
847 |
Number Of Black or African American Beneficiaries |
88 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
664 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
298 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
63 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.0711 |