National Provider Identifier [NPI]: |
1205910882 |
Last Name Of The Provider |
UDWADIA |
First Name Of The Provider |
NEVILLE |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
224-2 SAN JOSE STREET |
Street Address 2 Of The Provider |
#2 |
City Of The Provider |
SALINAS |
Zip Code Of The Provider |
93901 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
2588 |
Number Of Medicare Beneficiaries |
642 |
Total Submitted Charge Amount |
620570 |
Total Medicare Allowed Amount |
312914.44 |
Total Medicare Payment Amount |
225677.22 |
Total Medicare Standardized Payment Amount |
218857.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
480 |
Total Drug Medicare AllowedAmount |
50.07 |
Total Drug Medicare PaymentAmount |
39.29 |
Total Drug Medicare Standardized Payment Amount |
39.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
2573 |
Number Of Medicare Beneficiaries With Medical Services |
642 |
Total Medical Submitted Charge Amount |
620090 |
Total Medical Medicare Allowed Amount |
312864.37 |
Total Medical Medicare Payment Amount |
225637.93 |
Total Medical Medicare Standardized Payment Amount |
218817.89 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
250 |
Number Of Beneficiaries Age 75 to 84 |
219 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
463 |
Number Of Male Beneficiaries |
179 |
Number Of Non Hispanic White Beneficiaries |
403 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
41 |
Number Of Hispanic Beneficiaries |
156 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
477 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
165 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
27 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2484 |