National Provider Identifier [NPI]: |
1366601262 |
Last Name Of The Provider |
AMBATI |
First Name Of The Provider |
RAJITHA |
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 |
400 AUSTIN AVE NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
MASSILLON |
Zip Code Of The Provider |
446463554 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
930 |
Number Of Medicare Beneficiaries |
258 |
Total Submitted Charge Amount |
82988.79 |
Total Medicare Allowed Amount |
77813.95 |
Total Medicare Payment Amount |
59794.99 |
Total Medicare Standardized Payment Amount |
61690.73 |
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 |
12 |
Number Of Medical Services |
930 |
Number Of Medicare Beneficiaries With Medical Services |
258 |
Total Medical Submitted Charge Amount |
82988.79 |
Total Medical Medicare Allowed Amount |
77813.95 |
Total Medical Medicare Payment Amount |
59794.99 |
Total Medical Medicare Standardized Payment Amount |
61690.73 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
233 |
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 |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3006 |