National Provider Identifier [NPI]: |
1457316895 |
Last Name Of The Provider |
PATEL |
First Name Of The Provider |
DEVBALA |
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 |
71 HAYNES ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MANCHESTER |
Zip Code Of The Provider |
060404131 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
3377 |
Number Of Medicare Beneficiaries |
748 |
Total Submitted Charge Amount |
659155 |
Total Medicare Allowed Amount |
165480.21 |
Total Medicare Payment Amount |
129551.76 |
Total Medicare Standardized Payment Amount |
90526.21 |
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 |
27 |
Number Of Medical Services |
3377 |
Number Of Medicare Beneficiaries With Medical Services |
748 |
Total Medical Submitted Charge Amount |
659155 |
Total Medical Medicare Allowed Amount |
165480.21 |
Total Medical Medicare Payment Amount |
129551.76 |
Total Medical Medicare Standardized Payment Amount |
90526.21 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
135 |
Number Of Beneficiaries Age 65 to 74 |
316 |
Number Of Beneficiaries Age 75 to 84 |
226 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
425 |
Number Of Male Beneficiaries |
323 |
Number Of Non Hispanic White Beneficiaries |
664 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
536 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
212 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1313 |