| National Provider Identifier [NPI]: | 1578874368 |
| Last Name Of The Provider | GAJENDRA |
| First Name Of The Provider | NISHA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1559 W MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEWISVILLE |
| Zip Code Of The Provider | 750673394 |
| 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 | 33 |
| Number Of Services | 498 |
| Number Of Medicare Beneficiaries | 144 |
| Total Submitted Charge Amount | 58535 |
| Total Medicare Allowed Amount | 36974.08 |
| Total Medicare Payment Amount | 29103.96 |
| Total Medicare Standardized Payment Amount | 29348.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 785 |
| Total Drug Medicare AllowedAmount | 328.54 |
| Total Drug Medicare PaymentAmount | 318.36 |
| Total Drug Medicare Standardized Payment Amount | 318.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 473 |
| Number Of Medicare Beneficiaries With Medical Services | 144 |
| Total Medical Submitted Charge Amount | 57750 |
| Total Medical Medicare Allowed Amount | 36645.54 |
| Total Medical Medicare Payment Amount | 28785.6 |
| Total Medical Medicare Standardized Payment Amount | 29029.73 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 41 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 99 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 76 |
| Number Of Black or African American Beneficiaries | 45 |
| 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 | 49 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7112 |