National Provider Identifier [NPI]: |
1497727630 |
Last Name Of The Provider |
SIVA |
First Name Of The Provider |
SADHISH |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1004 N HIGHLAND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MURFREESBORO |
Zip Code Of The Provider |
371302454 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
176 |
Number Of Services |
5424 |
Number Of Medicare Beneficiaries |
2498 |
Total Submitted Charge Amount |
1491107.75 |
Total Medicare Allowed Amount |
529313.22 |
Total Medicare Payment Amount |
411828.39 |
Total Medicare Standardized Payment Amount |
461089.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
382 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
1945 |
Total Drug Medicare AllowedAmount |
1701.88 |
Total Drug Medicare PaymentAmount |
1334.26 |
Total Drug Medicare Standardized Payment Amount |
1334.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
170 |
Number Of Medical Services |
5042 |
Number Of Medicare Beneficiaries With Medical Services |
2498 |
Total Medical Submitted Charge Amount |
1489162.75 |
Total Medical Medicare Allowed Amount |
527611.34 |
Total Medical Medicare Payment Amount |
410494.13 |
Total Medical Medicare Standardized Payment Amount |
459755.49 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
310 |
Number Of Beneficiaries Age 65 to 74 |
1233 |
Number Of Beneficiaries Age 75 to 84 |
737 |
Number Of Beneficiaries Age Greater 84 |
218 |
Number Of Female Beneficiaries |
1909 |
Number Of Male Beneficiaries |
589 |
Number Of Non Hispanic White Beneficiaries |
2309 |
Number Of Black or African American Beneficiaries |
113 |
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
29 |
Number Of Beneficiaries With Medicare Only Entitlement |
2252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
246 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0215 |