National Provider Identifier [NPI]: |
1124261532 |
Last Name Of The Provider |
KOLLURU |
First Name Of The Provider |
ANURADHA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2300 N EDWARD ST |
Street Address 2 Of The Provider |
SUITE 2400 |
City Of The Provider |
DECATUR |
Zip Code Of The Provider |
625264163 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
2974 |
Number Of Medicare Beneficiaries |
1047 |
Total Submitted Charge Amount |
664092.1 |
Total Medicare Allowed Amount |
176228.84 |
Total Medicare Payment Amount |
134968.61 |
Total Medicare Standardized Payment Amount |
138622.94 |
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 |
43 |
Number Of Medical Services |
2974 |
Number Of Medicare Beneficiaries With Medical Services |
1047 |
Total Medical Submitted Charge Amount |
664092.1 |
Total Medical Medicare Allowed Amount |
176228.84 |
Total Medical Medicare Payment Amount |
134968.61 |
Total Medical Medicare Standardized Payment Amount |
138622.94 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
145 |
Number Of Beneficiaries Age 65 to 74 |
369 |
Number Of Beneficiaries Age 75 to 84 |
334 |
Number Of Beneficiaries Age Greater 84 |
199 |
Number Of Female Beneficiaries |
596 |
Number Of Male Beneficiaries |
451 |
Number Of Non Hispanic White Beneficiaries |
927 |
Number Of Black or African American Beneficiaries |
109 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
820 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
227 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.668 |