National Provider Identifier [NPI]: |
1386841963 |
Last Name Of The Provider |
NANDA |
First Name Of The Provider |
VIR |
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 |
12998 HESPERIA RD |
Street Address 2 Of The Provider |
SUITE 204 |
City Of The Provider |
VICTORVILLE |
Zip Code Of The Provider |
923958316 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
103 |
Number Of Services |
118204 |
Number Of Medicare Beneficiaries |
705 |
Total Submitted Charge Amount |
4305644.08 |
Total Medicare Allowed Amount |
1499888.66 |
Total Medicare Payment Amount |
1164052.91 |
Total Medicare Standardized Payment Amount |
1136401.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
63 |
Number Of Drug Services |
112201 |
Number Of Medicare Beneficiaries With Drug Services |
167 |
Total Drug Submitted ChargeAmount |
3319702.03 |
Total Drug Medicare AllowedAmount |
1106358.87 |
Total Drug Medicare PaymentAmount |
865957.34 |
Total Drug Medicare Standardized Payment Amount |
865957.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
6003 |
Number Of Medicare Beneficiaries With Medical Services |
705 |
Total Medical Submitted Charge Amount |
985942.05 |
Total Medical Medicare Allowed Amount |
393529.79 |
Total Medical Medicare Payment Amount |
298095.57 |
Total Medical Medicare Standardized Payment Amount |
270444.03 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
279 |
Number Of Beneficiaries Age 75 to 84 |
222 |
Number Of Beneficiaries Age Greater 84 |
88 |
Number Of Female Beneficiaries |
394 |
Number Of Male Beneficiaries |
311 |
Number Of Non Hispanic White Beneficiaries |
462 |
Number Of Black or African American Beneficiaries |
98 |
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
119 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
494 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
211 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
49 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.0973 |