National Provider Identifier [NPI]: |
1790729812 |
Last Name Of The Provider |
RAJ |
First Name Of The Provider |
ARTI |
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 |
7905 CALUMET AVE |
Street Address 2 Of The Provider |
HAMMOND CLINIC LLC |
City Of The Provider |
MUNSTER |
Zip Code Of The Provider |
463211215 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
127 |
Number Of Services |
2660 |
Number Of Medicare Beneficiaries |
1832 |
Total Submitted Charge Amount |
634960 |
Total Medicare Allowed Amount |
84453.09 |
Total Medicare Payment Amount |
66779.71 |
Total Medicare Standardized Payment Amount |
68372.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
127 |
Number Of Medical Services |
2660 |
Number Of Medicare Beneficiaries With Medical Services |
1832 |
Total Medical Submitted Charge Amount |
634960 |
Total Medical Medicare Allowed Amount |
84453.09 |
Total Medical Medicare Payment Amount |
66779.71 |
Total Medical Medicare Standardized Payment Amount |
68372.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
234 |
Number Of Beneficiaries Age 65 to 74 |
887 |
Number Of Beneficiaries Age 75 to 84 |
499 |
Number Of Beneficiaries Age Greater 84 |
212 |
Number Of Female Beneficiaries |
1262 |
Number Of Male Beneficiaries |
570 |
Number Of Non Hispanic White Beneficiaries |
1357 |
Number Of Black or African American Beneficiaries |
280 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
169 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
1603 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
229 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1306 |