National Provider Identifier [NPI]: |
1639226335 |
Last Name Of The Provider |
RAVEE |
First Name Of The Provider |
MANI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2525 DESALES AVENUE |
Street Address 2 Of The Provider |
MEMORIAL HOSPITALIST PROGRAM |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
37404 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
704 |
Number Of Medicare Beneficiaries |
654 |
Total Submitted Charge Amount |
247678 |
Total Medicare Allowed Amount |
131746.08 |
Total Medicare Payment Amount |
102021.26 |
Total Medicare Standardized Payment Amount |
108679.74 |
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 |
13 |
Number Of Medical Services |
704 |
Number Of Medicare Beneficiaries With Medical Services |
654 |
Total Medical Submitted Charge Amount |
247678 |
Total Medical Medicare Allowed Amount |
131746.08 |
Total Medical Medicare Payment Amount |
102021.26 |
Total Medical Medicare Standardized Payment Amount |
108679.74 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
183 |
Number Of Beneficiaries Age 75 to 84 |
200 |
Number Of Beneficiaries Age Greater 84 |
162 |
Number Of Female Beneficiaries |
380 |
Number Of Male Beneficiaries |
274 |
Number Of Non Hispanic White Beneficiaries |
572 |
Number Of Black or African American Beneficiaries |
|
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 |
465 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
189 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.9423 |