National Provider Identifier [NPI]: |
1275531162 |
Last Name Of The Provider |
GAJERA |
First Name Of The Provider |
RATILAL |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1717 HIGH ST |
Street Address 2 Of The Provider |
SUITE 1A |
City Of The Provider |
HOPKINSVILLE |
Zip Code Of The Provider |
422406300 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
93 |
Number Of Services |
112807 |
Number Of Medicare Beneficiaries |
896 |
Total Submitted Charge Amount |
3886606 |
Total Medicare Allowed Amount |
1892773.71 |
Total Medicare Payment Amount |
1471292.02 |
Total Medicare Standardized Payment Amount |
1496730.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
52 |
Number Of Drug Services |
98912 |
Number Of Medicare Beneficiaries With Drug Services |
414 |
Total Drug Submitted ChargeAmount |
3132313 |
Total Drug Medicare AllowedAmount |
1421518.7 |
Total Drug Medicare PaymentAmount |
1108367.85 |
Total Drug Medicare Standardized Payment Amount |
1108367.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
13895 |
Number Of Medicare Beneficiaries With Medical Services |
896 |
Total Medical Submitted Charge Amount |
754293 |
Total Medical Medicare Allowed Amount |
471255.01 |
Total Medical Medicare Payment Amount |
362924.17 |
Total Medical Medicare Standardized Payment Amount |
388362.95 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
152 |
Number Of Beneficiaries Age 65 to 74 |
370 |
Number Of Beneficiaries Age 75 to 84 |
278 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
583 |
Number Of Male Beneficiaries |
313 |
Number Of Non Hispanic White Beneficiaries |
730 |
Number Of Black or African American Beneficiaries |
151 |
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 |
671 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
225 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
42 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6585 |