National Provider Identifier [NPI]: |
1215982137 |
Last Name Of The Provider |
SASTRY |
First Name Of The Provider |
LALITHA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15855 WEST 19 MILE RD |
Street Address 2 Of The Provider |
ST JOSEPHS MEDICAL CENTER |
City Of The Provider |
CLINTON TWP |
Zip Code Of The Provider |
48038 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1036 |
Number Of Medicare Beneficiaries |
450 |
Total Submitted Charge Amount |
130400 |
Total Medicare Allowed Amount |
33721.99 |
Total Medicare Payment Amount |
26281.94 |
Total Medicare Standardized Payment Amount |
20254.49 |
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 |
19 |
Number Of Medical Services |
1036 |
Number Of Medicare Beneficiaries With Medical Services |
450 |
Total Medical Submitted Charge Amount |
130400 |
Total Medical Medicare Allowed Amount |
33721.99 |
Total Medical Medicare Payment Amount |
26281.94 |
Total Medical Medicare Standardized Payment Amount |
20254.49 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
132 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
255 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
327 |
Number Of Black or African American Beneficiaries |
93 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
265 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
185 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1233 |