National Provider Identifier [NPI]: |
1114194743 |
Last Name Of The Provider |
VADDE |
First Name Of The Provider |
ANANTH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD MPH |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1364 CLIFTON RD NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303221059 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1080 |
Number Of Medicare Beneficiaries |
339 |
Total Submitted Charge Amount |
331188 |
Total Medicare Allowed Amount |
121193.7 |
Total Medicare Payment Amount |
93937.23 |
Total Medicare Standardized Payment Amount |
94926.37 |
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 |
15 |
Number Of Medical Services |
1080 |
Number Of Medicare Beneficiaries With Medical Services |
339 |
Total Medical Submitted Charge Amount |
331188 |
Total Medical Medicare Allowed Amount |
121193.7 |
Total Medical Medicare Payment Amount |
93937.23 |
Total Medical Medicare Standardized Payment Amount |
94926.37 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
199 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
188 |
Number Of Black or African American Beneficiaries |
135 |
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 |
232 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
3.1074 |