National Provider Identifier [NPI]: |
1730481771 |
Last Name Of The Provider |
BULUSU |
First Name Of The Provider |
KIRANMAYI |
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 |
401 15TH AVE SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PUYALLUP |
Zip Code Of The Provider |
983723715 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1136 |
Number Of Medicare Beneficiaries |
405 |
Total Submitted Charge Amount |
244041 |
Total Medicare Allowed Amount |
113275.28 |
Total Medicare Payment Amount |
88690 |
Total Medicare Standardized Payment Amount |
89527.82 |
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 |
17 |
Number Of Medical Services |
1136 |
Number Of Medicare Beneficiaries With Medical Services |
405 |
Total Medical Submitted Charge Amount |
244041 |
Total Medical Medicare Allowed Amount |
113275.28 |
Total Medical Medicare Payment Amount |
88690 |
Total Medical Medicare Standardized Payment Amount |
89527.82 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
166 |
Number Of Non Hispanic White Beneficiaries |
361 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
13 |
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 |
295 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.3203 |