National Provider Identifier [NPI]: |
1316190754 |
Last Name Of The Provider |
GOVATHOTI |
First Name Of The Provider |
DEEPTI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1301 MEMORIAL DR |
Street Address 2 Of The Provider |
#200 |
City Of The Provider |
BRYAN |
Zip Code Of The Provider |
778025205 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1990 |
Number Of Medicare Beneficiaries |
560 |
Total Submitted Charge Amount |
462024 |
Total Medicare Allowed Amount |
232453.25 |
Total Medicare Payment Amount |
179780.58 |
Total Medicare Standardized Payment Amount |
186305.74 |
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 |
26 |
Number Of Medical Services |
1990 |
Number Of Medicare Beneficiaries With Medical Services |
560 |
Total Medical Submitted Charge Amount |
462024 |
Total Medical Medicare Allowed Amount |
232453.25 |
Total Medical Medicare Payment Amount |
179780.58 |
Total Medical Medicare Standardized Payment Amount |
186305.74 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
146 |
Number Of Female Beneficiaries |
332 |
Number Of Male Beneficiaries |
228 |
Number Of Non Hispanic White Beneficiaries |
446 |
Number Of Black or African American Beneficiaries |
100 |
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 |
317 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
243 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
1.8871 |