National Provider Identifier [NPI]: |
1659445831 |
Last Name Of The Provider |
PATEL |
First Name Of The Provider |
KASHIBEN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3100 WYMAN PARK DRIVE |
Street Address 2 Of The Provider |
SUITE 359A |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
21211 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
931 |
Number Of Medicare Beneficiaries |
186 |
Total Submitted Charge Amount |
168190 |
Total Medicare Allowed Amount |
74481.28 |
Total Medicare Payment Amount |
53891.67 |
Total Medicare Standardized Payment Amount |
51379.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
83 |
Number Of Medicare Beneficiaries With Drug Services |
58 |
Total Drug Submitted ChargeAmount |
3037 |
Total Drug Medicare AllowedAmount |
1321.63 |
Total Drug Medicare PaymentAmount |
1274.86 |
Total Drug Medicare Standardized Payment Amount |
1274.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
848 |
Number Of Medicare Beneficiaries With Medical Services |
186 |
Total Medical Submitted Charge Amount |
165153 |
Total Medical Medicare Allowed Amount |
73159.65 |
Total Medical Medicare Payment Amount |
52616.81 |
Total Medical Medicare Standardized Payment Amount |
50105.1 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
138 |
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 |
134 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2712 |