National Provider Identifier [NPI]: |
1790764587 |
Last Name Of The Provider |
ARUNACHALAM |
First Name Of The Provider |
VIJAYALAKSHMI |
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 |
4900 MERCURY DR |
Street Address 2 Of The Provider |
STE 201 |
City Of The Provider |
DEARBORN |
Zip Code Of The Provider |
481262947 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
578 |
Number Of Medicare Beneficiaries |
200 |
Total Submitted Charge Amount |
49943 |
Total Medicare Allowed Amount |
41469.4 |
Total Medicare Payment Amount |
26774.52 |
Total Medicare Standardized Payment Amount |
25975.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
471 |
Total Drug Medicare AllowedAmount |
325.78 |
Total Drug Medicare PaymentAmount |
265.02 |
Total Drug Medicare Standardized Payment Amount |
265.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
526 |
Number Of Medicare Beneficiaries With Medical Services |
200 |
Total Medical Submitted Charge Amount |
49472 |
Total Medical Medicare Allowed Amount |
41143.62 |
Total Medical Medicare Payment Amount |
26509.5 |
Total Medical Medicare Standardized Payment Amount |
25710.06 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
110 |
Number Of Black or African American Beneficiaries |
66 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
109 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4432 |