National Provider Identifier [NPI]: |
1710206545 |
Last Name Of The Provider |
JARIWALA |
First Name Of The Provider |
NEIL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
515 BAYOU ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
VINCENNES |
Zip Code Of The Provider |
475911034 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
508 |
Number Of Medicare Beneficiaries |
239 |
Total Submitted Charge Amount |
66110 |
Total Medicare Allowed Amount |
38271.25 |
Total Medicare Payment Amount |
29423.1 |
Total Medicare Standardized Payment Amount |
30747.9 |
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 |
6 |
Number Of Medical Services |
508 |
Number Of Medicare Beneficiaries With Medical Services |
239 |
Total Medical Submitted Charge Amount |
66110 |
Total Medical Medicare Allowed Amount |
38271.25 |
Total Medical Medicare Payment Amount |
29423.1 |
Total Medical Medicare Standardized Payment Amount |
30747.9 |
Average Age Of Beneficiaries |
54 |
Number Of Beneficiaries Age Less65 |
179 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
50 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
189 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
64 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
49 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2776 |