National Provider Identifier [NPI]: |
1750598363 |
Last Name Of The Provider |
SRINIVASAN |
First Name Of The Provider |
SRIDHAR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1706 ALICE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WAYCROSS |
Zip Code Of The Provider |
315015216 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
16665 |
Number Of Medicare Beneficiaries |
715 |
Total Submitted Charge Amount |
502781.8 |
Total Medicare Allowed Amount |
280340.81 |
Total Medicare Payment Amount |
218057.24 |
Total Medicare Standardized Payment Amount |
228265.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
13440 |
Number Of Medicare Beneficiaries With Drug Services |
42 |
Total Drug Submitted ChargeAmount |
140470.8 |
Total Drug Medicare AllowedAmount |
54201.99 |
Total Drug Medicare PaymentAmount |
42494.39 |
Total Drug Medicare Standardized Payment Amount |
42494.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
3225 |
Number Of Medicare Beneficiaries With Medical Services |
714 |
Total Medical Submitted Charge Amount |
362311 |
Total Medical Medicare Allowed Amount |
226138.82 |
Total Medical Medicare Payment Amount |
175562.85 |
Total Medical Medicare Standardized Payment Amount |
185770.7 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
172 |
Number Of Beneficiaries Age 65 to 74 |
285 |
Number Of Beneficiaries Age 75 to 84 |
194 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
442 |
Number Of Male Beneficiaries |
273 |
Number Of Non Hispanic White Beneficiaries |
555 |
Number Of Black or African American Beneficiaries |
145 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
457 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
258 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
37 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.979 |