National Provider Identifier [NPI]: |
1265716542 |
Last Name Of The Provider |
BHANGOO |
First Name Of The Provider |
SANDEEP |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
N.P |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2351 W MARCH LN |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
STOCKTON |
Zip Code Of The Provider |
952075292 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
886 |
Number Of Medicare Beneficiaries |
122 |
Total Submitted Charge Amount |
196775.31 |
Total Medicare Allowed Amount |
151860.59 |
Total Medicare Payment Amount |
118513 |
Total Medicare Standardized Payment Amount |
130189.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
178 |
Number Of Medicare Beneficiaries With Drug Services |
44 |
Total Drug Submitted ChargeAmount |
21305 |
Total Drug Medicare AllowedAmount |
16064.32 |
Total Drug Medicare PaymentAmount |
12594.6 |
Total Drug Medicare Standardized Payment Amount |
12594.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
708 |
Number Of Medicare Beneficiaries With Medical Services |
122 |
Total Medical Submitted Charge Amount |
175470.31 |
Total Medical Medicare Allowed Amount |
135796.27 |
Total Medical Medicare Payment Amount |
105918.4 |
Total Medical Medicare Standardized Payment Amount |
117595.2 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
54 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
62 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3827 |