National Provider Identifier [NPI]: |
1932170933 |
Last Name Of The Provider |
MEHTA |
First Name Of The Provider |
JYOTI |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1001 W MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WILLIAMSBURG |
Zip Code Of The Provider |
451761146 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
4504 |
Number Of Medicare Beneficiaries |
739 |
Total Submitted Charge Amount |
524209 |
Total Medicare Allowed Amount |
366352.81 |
Total Medicare Payment Amount |
267159.19 |
Total Medicare Standardized Payment Amount |
274720.66 |
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 |
4504 |
Number Of Medicare Beneficiaries With Medical Services |
739 |
Total Medical Submitted Charge Amount |
524209 |
Total Medical Medicare Allowed Amount |
366352.81 |
Total Medical Medicare Payment Amount |
267159.19 |
Total Medical Medicare Standardized Payment Amount |
274720.66 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
166 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
204 |
Number Of Beneficiaries Age Greater 84 |
177 |
Number Of Female Beneficiaries |
476 |
Number Of Male Beneficiaries |
263 |
Number Of Non Hispanic White Beneficiaries |
721 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
317 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
422 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
42 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.205 |