National Provider Identifier [NPI]: |
1083668248 |
Last Name Of The Provider |
PANT |
First Name Of The Provider |
SUSHMA |
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 |
1250 IDAHO STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEWISTON |
Zip Code Of The Provider |
83501 |
State Code Of The Provider |
ID |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1403 |
Number Of Medicare Beneficiaries |
494 |
Total Submitted Charge Amount |
333728.5 |
Total Medicare Allowed Amount |
113074.45 |
Total Medicare Payment Amount |
85948.07 |
Total Medicare Standardized Payment Amount |
92365.78 |
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 |
13 |
Number Of Medical Services |
1403 |
Number Of Medicare Beneficiaries With Medical Services |
494 |
Total Medical Submitted Charge Amount |
333728.5 |
Total Medical Medicare Allowed Amount |
113074.45 |
Total Medical Medicare Payment Amount |
85948.07 |
Total Medical Medicare Standardized Payment Amount |
92365.78 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
197 |
Number Of Beneficiaries Age 75 to 84 |
179 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
380 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
480 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
427 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
62 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.5341 |