National Provider Identifier [NPI]: |
1235239013 |
Last Name Of The Provider |
TAMMANA |
First Name Of The Provider |
SWARNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1502 NORTH MAIN STREET |
Street Address 2 Of The Provider |
SUITE 304 |
City Of The Provider |
MT. AIRY |
Zip Code Of The Provider |
21771 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
837 |
Number Of Medicare Beneficiaries |
124 |
Total Submitted Charge Amount |
83796 |
Total Medicare Allowed Amount |
49421.44 |
Total Medicare Payment Amount |
35652.58 |
Total Medicare Standardized Payment Amount |
33618.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
63 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
1663 |
Total Drug Medicare AllowedAmount |
1139.34 |
Total Drug Medicare PaymentAmount |
1113.7 |
Total Drug Medicare Standardized Payment Amount |
1113.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
774 |
Number Of Medicare Beneficiaries With Medical Services |
124 |
Total Medical Submitted Charge Amount |
82133 |
Total Medical Medicare Allowed Amount |
48282.1 |
Total Medical Medicare Payment Amount |
34538.88 |
Total Medical Medicare Standardized Payment Amount |
32505.02 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
113 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
100 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9065 |