National Provider Identifier [NPI]: |
1629074596 |
Last Name Of The Provider |
VASUDEVA |
First Name Of The Provider |
INDI |
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 |
2810 W SAINT ISABEL ST |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336076375 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
2678 |
Number Of Medicare Beneficiaries |
263 |
Total Submitted Charge Amount |
415238.49 |
Total Medicare Allowed Amount |
288336.82 |
Total Medicare Payment Amount |
224157.91 |
Total Medicare Standardized Payment Amount |
223113.07 |
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 |
7 |
Number Of Medical Services |
2678 |
Number Of Medicare Beneficiaries With Medical Services |
263 |
Total Medical Submitted Charge Amount |
415238.49 |
Total Medical Medicare Allowed Amount |
288336.82 |
Total Medical Medicare Payment Amount |
224157.91 |
Total Medical Medicare Standardized Payment Amount |
223113.07 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
130 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
137 |
Number Of Black or African American Beneficiaries |
95 |
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 |
125 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
4.9353 |