National Provider Identifier [NPI]: |
1609027333 |
Last Name Of The Provider |
GUNTUR |
First Name Of The Provider |
RAKESH |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11109 PARKVIEW PLAZA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468451701 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
881 |
Number Of Medicare Beneficiaries |
377 |
Total Submitted Charge Amount |
245935 |
Total Medicare Allowed Amount |
85719 |
Total Medicare Payment Amount |
65148.3 |
Total Medicare Standardized Payment Amount |
66977.2 |
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 |
20 |
Number Of Medical Services |
881 |
Number Of Medicare Beneficiaries With Medical Services |
377 |
Total Medical Submitted Charge Amount |
245935 |
Total Medical Medicare Allowed Amount |
85719 |
Total Medical Medicare Payment Amount |
65148.3 |
Total Medical Medicare Standardized Payment Amount |
66977.2 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
180 |
Number Of Non Hispanic White Beneficiaries |
324 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
275 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
24 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.3599 |