National Provider Identifier [NPI]: |
1538328844 |
Last Name Of The Provider |
SUKUMARAN |
First Name Of The Provider |
NISHANTH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
34 MEDICAL PARK BLVD |
Street Address 2 Of The Provider |
SUITE # G |
City Of The Provider |
PETERSBURG |
Zip Code Of The Provider |
238059283 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
61146 |
Number Of Medicare Beneficiaries |
533 |
Total Submitted Charge Amount |
2393749 |
Total Medicare Allowed Amount |
964301.74 |
Total Medicare Payment Amount |
756499.22 |
Total Medicare Standardized Payment Amount |
752409.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
46 |
Number Of Drug Services |
53420 |
Number Of Medicare Beneficiaries With Drug Services |
103 |
Total Drug Submitted ChargeAmount |
1628324 |
Total Drug Medicare AllowedAmount |
629457.38 |
Total Drug Medicare PaymentAmount |
492956.97 |
Total Drug Medicare Standardized Payment Amount |
492956.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
7726 |
Number Of Medicare Beneficiaries With Medical Services |
533 |
Total Medical Submitted Charge Amount |
765425 |
Total Medical Medicare Allowed Amount |
334844.36 |
Total Medical Medicare Payment Amount |
263542.25 |
Total Medical Medicare Standardized Payment Amount |
259452.9 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
84 |
Number Of Beneficiaries Age 65 to 74 |
186 |
Number Of Beneficiaries Age 75 to 84 |
171 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
339 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
198 |
Number Of Black or African American Beneficiaries |
320 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
371 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
162 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
37 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.2091 |