National Provider Identifier [NPI]: |
1356509004 |
Last Name Of The Provider |
GADAM |
First Name Of The Provider |
MOHAN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12221 N MOPAC EXPY |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
787582401 |
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 |
14 |
Number Of Services |
829 |
Number Of Medicare Beneficiaries |
310 |
Total Submitted Charge Amount |
113853.63 |
Total Medicare Allowed Amount |
79497.03 |
Total Medicare Payment Amount |
62152.7 |
Total Medicare Standardized Payment Amount |
63378.69 |
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 |
14 |
Number Of Medical Services |
829 |
Number Of Medicare Beneficiaries With Medical Services |
310 |
Total Medical Submitted Charge Amount |
113853.63 |
Total Medical Medicare Allowed Amount |
79497.03 |
Total Medical Medicare Payment Amount |
62152.7 |
Total Medical Medicare Standardized Payment Amount |
63378.69 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
185 |
Number Of Male Beneficiaries |
125 |
Number Of Non Hispanic White Beneficiaries |
198 |
Number Of Black or African American Beneficiaries |
29 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
72 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.44 |