National Provider Identifier [NPI]: |
1043402472 |
Last Name Of The Provider |
MADAMALA |
First Name Of The Provider |
NAVYA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15 SALT CREEK LN |
Street Address 2 Of The Provider |
SUITE 111, IPC |
City Of The Provider |
HINSDALE |
Zip Code Of The Provider |
605212926 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
792 |
Number Of Medicare Beneficiaries |
152 |
Total Submitted Charge Amount |
159669 |
Total Medicare Allowed Amount |
79766.9 |
Total Medicare Payment Amount |
62535.05 |
Total Medicare Standardized Payment Amount |
58773.93 |
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 |
10 |
Number Of Medical Services |
792 |
Number Of Medicare Beneficiaries With Medical Services |
152 |
Total Medical Submitted Charge Amount |
159669 |
Total Medical Medicare Allowed Amount |
79766.9 |
Total Medical Medicare Payment Amount |
62535.05 |
Total Medical Medicare Standardized Payment Amount |
58773.93 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
88 |
Number Of Black or African American Beneficiaries |
|
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 |
53 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
67 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
68 |
Percent Of With Chronic Kidney Disease |
71 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
4.7185 |