National Provider Identifier [NPI]: |
1881655439 |
Last Name Of The Provider |
LALLI |
First Name Of The Provider |
BALDEV |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1950 LEE RD |
Street Address 2 Of The Provider |
SUITE 105 |
City Of The Provider |
WINTER PARK |
Zip Code Of The Provider |
327891859 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
614 |
Number Of Medicare Beneficiaries |
550 |
Total Submitted Charge Amount |
337433.68 |
Total Medicare Allowed Amount |
88203.75 |
Total Medicare Payment Amount |
66042.05 |
Total Medicare Standardized Payment Amount |
65368.25 |
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 |
5 |
Number Of Medical Services |
614 |
Number Of Medicare Beneficiaries With Medical Services |
550 |
Total Medical Submitted Charge Amount |
337433.68 |
Total Medical Medicare Allowed Amount |
88203.75 |
Total Medical Medicare Payment Amount |
66042.05 |
Total Medical Medicare Standardized Payment Amount |
65368.25 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
162 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
312 |
Number Of Male Beneficiaries |
238 |
Number Of Non Hispanic White Beneficiaries |
326 |
Number Of Black or African American Beneficiaries |
144 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
63 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
315 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
235 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.9741 |