National Provider Identifier [NPI]: |
1861682957 |
Last Name Of The Provider |
KULARATNA |
First Name Of The Provider |
GOWRI |
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 |
12070 OLD LINE CTR |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
WALDORF |
Zip Code Of The Provider |
206022513 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
918 |
Number Of Medicare Beneficiaries |
448 |
Total Submitted Charge Amount |
349377.48 |
Total Medicare Allowed Amount |
123188.32 |
Total Medicare Payment Amount |
94915.19 |
Total Medicare Standardized Payment Amount |
92790.13 |
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 |
31 |
Number Of Medical Services |
918 |
Number Of Medicare Beneficiaries With Medical Services |
448 |
Total Medical Submitted Charge Amount |
349377.48 |
Total Medical Medicare Allowed Amount |
123188.32 |
Total Medical Medicare Payment Amount |
94915.19 |
Total Medical Medicare Standardized Payment Amount |
92790.13 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
308 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
206 |
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 |
349 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.564 |