National Provider Identifier [NPI]: |
1699728584 |
Last Name Of The Provider |
MEHRA |
First Name Of The Provider |
MUKTESHWAR |
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 |
2901 OLD JACKSONVILLE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627047437 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1299 |
Number Of Medicare Beneficiaries |
313 |
Total Submitted Charge Amount |
414819 |
Total Medicare Allowed Amount |
134812.23 |
Total Medicare Payment Amount |
99049.1 |
Total Medicare Standardized Payment Amount |
89848.05 |
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 |
18 |
Number Of Medical Services |
1299 |
Number Of Medicare Beneficiaries With Medical Services |
313 |
Total Medical Submitted Charge Amount |
414819 |
Total Medical Medicare Allowed Amount |
134812.23 |
Total Medical Medicare Payment Amount |
99049.1 |
Total Medical Medicare Standardized Payment Amount |
89848.05 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
93 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
170 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
298 |
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 |
202 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4396 |