National Provider Identifier [NPI]: |
1043283989 |
Last Name Of The Provider |
PEDDI |
First Name Of The Provider |
RAJESHWAR |
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 |
10010 KENNERLY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631282106 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Geriatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
1516 |
Number Of Medicare Beneficiaries |
535 |
Total Submitted Charge Amount |
218875.6 |
Total Medicare Allowed Amount |
131031.19 |
Total Medicare Payment Amount |
101501.33 |
Total Medicare Standardized Payment Amount |
102761.57 |
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 |
12 |
Number Of Medical Services |
1516 |
Number Of Medicare Beneficiaries With Medical Services |
535 |
Total Medical Submitted Charge Amount |
218875.6 |
Total Medical Medicare Allowed Amount |
131031.19 |
Total Medical Medicare Payment Amount |
101501.33 |
Total Medical Medicare Standardized Payment Amount |
102761.57 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
180 |
Number Of Beneficiaries Age Greater 84 |
127 |
Number Of Female Beneficiaries |
328 |
Number Of Male Beneficiaries |
207 |
Number Of Non Hispanic White Beneficiaries |
496 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
420 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.5378 |