National Provider Identifier [NPI]: |
1104834365 |
Last Name Of The Provider |
VODRA |
First Name Of The Provider |
JANET |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
140 GRANDVIEW AVE |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
WATERBURY |
Zip Code Of The Provider |
067082505 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
1088 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
130762.57 |
Total Medicare Allowed Amount |
71976.61 |
Total Medicare Payment Amount |
66921.17 |
Total Medicare Standardized Payment Amount |
62266.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
760 |
Total Drug Medicare AllowedAmount |
562.61 |
Total Drug Medicare PaymentAmount |
551.32 |
Total Drug Medicare Standardized Payment Amount |
551.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
1071 |
Number Of Medicare Beneficiaries With Medical Services |
268 |
Total Medical Submitted Charge Amount |
130002.57 |
Total Medical Medicare Allowed Amount |
71414 |
Total Medical Medicare Payment Amount |
66369.85 |
Total Medical Medicare Standardized Payment Amount |
61715.02 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
268 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
233 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
163 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.843 |