National Provider Identifier [NPI]: |
1740385210 |
Last Name Of The Provider |
JAYACHANDRAN |
First Name Of The Provider |
SHARMISHTHA |
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 |
300 RANDALL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GENEVA |
Zip Code Of The Provider |
601344200 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
140 |
Number Of Services |
3206 |
Number Of Medicare Beneficiaries |
1764 |
Total Submitted Charge Amount |
369327 |
Total Medicare Allowed Amount |
111104.99 |
Total Medicare Payment Amount |
89280.44 |
Total Medicare Standardized Payment Amount |
84952.38 |
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 |
140 |
Number Of Medical Services |
3206 |
Number Of Medicare Beneficiaries With Medical Services |
1764 |
Total Medical Submitted Charge Amount |
369327 |
Total Medical Medicare Allowed Amount |
111104.99 |
Total Medical Medicare Payment Amount |
89280.44 |
Total Medical Medicare Standardized Payment Amount |
84952.38 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
128 |
Number Of Beneficiaries Age 65 to 74 |
841 |
Number Of Beneficiaries Age 75 to 84 |
530 |
Number Of Beneficiaries Age Greater 84 |
265 |
Number Of Female Beneficiaries |
1348 |
Number Of Male Beneficiaries |
416 |
Number Of Non Hispanic White Beneficiaries |
1671 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
1595 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
169 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.1446 |