DR. CHANDANA MISHRA MD
NPI 1174626667
Internal Medicine - Endocrinology, Diabetes & Metabolism in Scottsdale, AZ

Medicare Participation & PECOS Enrollment Status

Chandana Mishra is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Chandana Mishra is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 4981618063

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20100920000114

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Other DME (DE017N)

  Supplies for maintenance of insulin infusion catheter, per week (HCPCS:A4224)

  4 DME suppliers used 13 Medicare Claims 180 Services Paid

• DME-Other DME (DE017N)

  Supplies for external insulin infusion pump, syringe type cartridge, sterile, each (HCPCS:A4225)

  4 DME suppliers used 16 Medicare Claims 520 Services Paid

• DME-Other DME (DE017N)

  Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

  31 DME suppliers used 65 Medicare Claims 213 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Lancets, per box of 100 (HCPCS:A4259)

  14 DME suppliers used 25 Medicare Claims 35 Services Paid

• DME-Other DME (DE017N)

  Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

  13 DME suppliers used 272 Medicare Claims 279 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Adrenocorticotropic hormone (acth) level

The Adrenocorticotropic Hormone (ACTH) level test is a blood test that checks the level of ACTH in your body. ACTH is a hormone produced in the pituitary gland that stimulates the adrenal glands to release cortisol, a hormone that helps regulate metabolism and immune response.

This service was performed 62 times for 50 patients

Aldosterone hormone level

Aldosterone hormone level test is a blood test that measures the amount of aldosterone, a hormone produced by your adrenal glands, in your blood. This hormone helps regulate salt, potassium, and fluid balance in your body. Imbalances may indicate certain adrenal or kidney conditions.

This service was performed 15 times for 15 patients

Analysis using chemiluminescent technique (light and chemical )reaction

Chemiluminescent analysis is a lab test that uses a special reaction between certain chemicals to produce light. This light is then measured to help understand specific elements in a sample. It is a non-invasive and highly accurate testing method.

This service was performed 66 times for 56 patients

Blood glucose (sugar) tolerance test, 3 specimens

A blood glucose tolerance test checks how your body manages sugar. It involves fasting, then drinking a sweet liquid. Blood is drawn before and twice after drinking to measure sugar levels. This helps identify potential issues like diabetes. It's safe and typically painless.

This service was performed 19 times for 18 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 1,550 times for 832 patients

Blood test, lipids (cholesterol and triglycerides)

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

This service was performed 947 times for 518 patients

Blood test, thyroid stimulating hormone (tsh)

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

This service was performed 1,629 times for 821 patients

Calculation of trabecular bone score (tbs) using imaging data with interpretation and report on fracture risk

Trabecular Bone Score (TBS) is a technique that uses imaging data to evaluate bone texture. It provides insight into bone strength, helping predict fracture risk. This information is then compiled into a report to aid in your bone health management.

This service was performed 203 times for 203 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 1,114 times for 654 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

This service was performed 146 times for 105 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment

This process involves a tiny sensor placed under your skin that checks your blood sugar levels in tissue fluid regularly. The sensor sends these readings to a device, allowing you to track your levels in real-time. This is provided by your healthcare provider.

This service was performed 24 times for 23 patients

Cortisol (hormone) measurement, total

Cortisol measurement is a test that checks the level of cortisol, a hormone, in your body. It's often used to assess stress levels or check for conditions like Addison's disease or Cushing's syndrome. This involves a simple blood or saliva sample.

This service was performed 86 times for 50 patients

C-peptide (protein) level

A C-peptide test measures the level of this protein in your blood. It's produced when your body makes insulin, a hormone that regulates your blood sugar. This test helps check how well your body is producing insulin and can aid in diagnosing conditions like diabetes.

This service was performed 155 times for 120 patients

Creatinine level to test for kidney function or muscle injury

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

This service was performed 305 times for 193 patients

Cyanocobalamin (vitamin b-12) level

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

This service was performed 525 times for 366 patients

Dxa bone density measurement of forearm, finger, hand, or foot

A DXA bone density measurement of the forearm, finger, hand, or foot is a non-invasive procedure that uses X-rays to measure the amount of calcium and other minerals in your bones. This test helps to assess the strength of your bones and your risk of fractures.

This service was performed 51 times for 51 patients

Dxa bone density measurement of hip, pelvis, spine

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

This service was performed 217 times for 216 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 100 times for 96 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 1,727 times for 909 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 107 times for 94 patients

Ferritin (blood protein) level

A Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.

This service was performed 370 times for 259 patients

Fine needle aspiration biopsy using ultrasound guidance, first growth

Fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.

This service was performed 60 times for 59 patients

Folic acid level, serum

A Folic Acid Level, Serum test measures the amount of folic acid, a type of B vitamin, in your blood. This vitamin is important for cell growth and development. It's crucial for your body to function well. If your levels are low, it may indicate a deficiency, which can lead to health issues.

This service was performed 466 times for 320 patients

Gonadotropin, follicle stimulating (reproductive hormone) level

This is a test that measures the level of a hormone in your body known as follicle stimulating hormone (FSH). FSH plays a key role in the body's reproductive processes. It's important for growth and the healthy functioning of the body.

This service was performed 31 times for 21 patients

Gonadotropin, luteinizing (reproductive hormone) level

This is a blood test that measures the level of luteinizing hormone (LH). LH plays a key role in body growth and development. It's important for the proper functioning of certain glands. Irregular levels can indicate potential health issues.

This service was performed 28 times for 21 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 1,053 times for 570 patients

Hormone receptor analysis

Hormone receptor analysis is a lab test done on tissue samples, often from a biopsy. This test checks for the presence of certain proteins that can indicate how your body is responding to hormones. The results can help doctors decide on the most effective treatment approach.

This service was performed 43 times for 32 patients

Human growth hormone level

The human growth hormone level test is a blood test that checks the amount of growth hormone in your body. This hormone is made by the pituitary gland and plays a key role in growth, body composition, and metabolism. Too much or too little can cause health issues.

This service was performed 19 times for 15 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 87 times for 38 patients

Injection, cosyntropin, 0.25 mg

Cosyntropin is a medication given via injection to test the health of your adrenal glands, which make important hormones in your body. The 0.25 mg dose helps determine if these glands are working properly.

This service was performed 17 times for 15 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

This service was performed 49 times for 31 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 1,781 times for 851 patients

Insulin measurement, total

Insulin measurement, total, is a blood test that checks the amount of insulin — a hormone regulating blood sugar — in your body. It helps diagnose diabetes and other conditions related to insulin. The test involves a simple blood draw and is generally safe and quick.

This service was performed 68 times for 40 patients

Iron binding capacity

Iron binding capacity is a blood test that measures how well your body can bind and transport iron. This helps your healthcare provider assess if your body has too little or too much iron, which can indicate certain health conditions.

This service was performed 365 times for 257 patients

Iron level

An iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.

This service was performed 364 times for 254 patients

Ldl cholesterol level

The LDL cholesterol level is a test that measures the amount of low-density lipoprotein (LDL) in your blood. LDL is often referred to as 'bad cholesterol' because high levels can lead to heart disease. Regular testing helps monitor and manage your heart health.

This service was performed 20 times for 16 patients

Magnesium level

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

This service was performed 92 times for 74 patients

Measurement of total estradiol (hormone)

Total estradiol measurement is a simple blood test that examines the level of a key hormone in your body. This hormone plays a vital role in many body functions. The test helps understand if hormone levels are balanced, which can impact overall health.

This service was performed 50 times for 34 patients

Microsomal antibodies (autoantibody) measurement

Microsomal antibodies measurement is a blood test to detect specific antibodies that your immune system may produce. It's often used to diagnose autoimmune conditions like thyroid disorders. The test is simple, involving a standard blood draw.

This service was performed 654 times for 472 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 163 times for 163 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 61 times for 61 patients

Parathormone (parathyroid hormone) level

The Parathormone level test measures the amount of parathyroid hormone in your blood. This hormone controls calcium and phosphorus levels in the body, which are vital for bone health. Abnormal levels may indicate issues like kidney disease or parathyroid gland disorders.

This service was performed 421 times for 290 patients

Phosphate level

A phosphate level test measures the amount of phosphate in your blood. Phosphate is a chemical that contains the mineral phosphorus, crucial for energy production, muscle and nerve function, and bone growth. Imbalances may indicate kidney disease or other health issues.

This service was performed 84 times for 75 patients

Prolactin (milk producing hormone) level

A prolactin level test measures the amount of a hormone, prolactin, in your blood. This hormone plays a role in many bodily functions, such as the creation of milk. High or low levels can indicate certain health conditions. The test involves a simple blood draw.

This service was performed 41 times for 30 patients

Psa (prostate specific antigen) measurement, total

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

This service was performed 46 times for 24 patients

Somatomedin (growth factor) level

A Somatomedin level test measures the amount of growth factors, specifically Insulin-like Growth Factor (IGF), in your body. These factors are crucial for growth and development. The test helps in diagnosing conditions related to growth abnormalities, like dwarfism or gigantism.

This service was performed 19 times for 16 patients

Testosterone (hormone) level, free

A free testosterone level test measures the amount of unattached, or "free," testosterone in your blood. Testosterone is a hormone that's important for certain body functions. This test is used to check if your hormone level is in the normal range.

This service was performed 64 times for 42 patients

Testosterone (hormone) level, total

A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.

This service was performed 70 times for 46 patients

Thyroglobulin (thyroid protein) antibody measurement

Thyroglobulin antibody measurement is a blood test that checks for antibodies against thyroglobulin, a protein in your thyroid gland. It helps detect conditions like Hashimoto's thyroiditis or monitor thyroid cancer treatment. It's a simple, safe procedure.

This service was performed 750 times for 515 patients

Thyroglobulin (thyroid related hormone) level

The Thyroglobulin level test measures the amount of thyroglobulin, a hormone produced by your thyroid gland, in your blood. It helps monitor thyroid health, particularly after thyroid cancer treatment, to check for recurrence.

This service was performed 116 times for 64 patients

Thyroid hormone, t3 measurement, free

The T3 measurement, free, is a blood test that checks the level of a hormone called triiodothyronine. This hormone is produced by your thyroid, a small gland in your neck. It plays a key role in regulating your body's metabolism and energy use.

This service was performed 1,625 times for 821 patients

Thyroxine (thyroid chemical), free

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

This service was performed 1,627 times for 821 patients

Ultrasound scan of head and neck soft tissue

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

This service was performed 487 times for 472 patients

Urine microalbumin (protein) level

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

This service was performed 306 times for 194 patients

Vitamin d-3 level

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

This service was performed 1,219 times for 710 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.92 for a new patient copayment and $24.5 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 85260 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 75 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: N/A

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: N/A

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: N/A

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

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