National Provider Identifier [NPI]: |
1740416544 |
Last Name Of The Provider |
PEDDI |
First Name Of The Provider |
HIMAJA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2800 L STREET, SUITE 610 |
Street Address 2 Of The Provider |
SUTTER MEDICAL FOUNDATION |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958165616 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
116 |
Number Of Services |
22883 |
Number Of Medicare Beneficiaries |
2687 |
Total Submitted Charge Amount |
1794455 |
Total Medicare Allowed Amount |
318644.26 |
Total Medicare Payment Amount |
241600.65 |
Total Medicare Standardized Payment Amount |
233577.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
19303 |
Number Of Medicare Beneficiaries With Drug Services |
224 |
Total Drug Submitted ChargeAmount |
43369 |
Total Drug Medicare AllowedAmount |
6431.58 |
Total Drug Medicare PaymentAmount |
5035.57 |
Total Drug Medicare Standardized Payment Amount |
5035.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
113 |
Number Of Medical Services |
3580 |
Number Of Medicare Beneficiaries With Medical Services |
2687 |
Total Medical Submitted Charge Amount |
1751086 |
Total Medical Medicare Allowed Amount |
312212.68 |
Total Medical Medicare Payment Amount |
236565.08 |
Total Medical Medicare Standardized Payment Amount |
228541.44 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
515 |
Number Of Beneficiaries Age 65 to 74 |
929 |
Number Of Beneficiaries Age 75 to 84 |
746 |
Number Of Beneficiaries Age Greater 84 |
497 |
Number Of Female Beneficiaries |
1555 |
Number Of Male Beneficiaries |
1132 |
Number Of Non Hispanic White Beneficiaries |
2053 |
Number Of Black or African American Beneficiaries |
154 |
Number Of AsianPacific Islander Beneficiaries |
175 |
Number Of Hispanic Beneficiaries |
238 |
Number Of American Indian Alaska Native Beneficiaries |
13 |
Number Of Beneficiaries With Race Not Else where Classified |
54 |
Number Of Beneficiaries With Medicare Only Entitlement |
1936 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
751 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.6467 |