National Provider Identifier [NPI]: |
1376592741 |
Last Name Of The Provider |
KHATOR |
First Name Of The Provider |
POOJA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
217 MANATEE AVE E |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRADENTON |
Zip Code Of The Provider |
342081931 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
4473 |
Number Of Medicare Beneficiaries |
1259 |
Total Submitted Charge Amount |
763521 |
Total Medicare Allowed Amount |
525295.66 |
Total Medicare Payment Amount |
374815.51 |
Total Medicare Standardized Payment Amount |
379110.11 |
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 |
41 |
Number Of Medical Services |
4473 |
Number Of Medicare Beneficiaries With Medical Services |
1259 |
Total Medical Submitted Charge Amount |
763521 |
Total Medical Medicare Allowed Amount |
525295.66 |
Total Medical Medicare Payment Amount |
374815.51 |
Total Medical Medicare Standardized Payment Amount |
379110.11 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
620 |
Number Of Beneficiaries Age 75 to 84 |
418 |
Number Of Beneficiaries Age Greater 84 |
168 |
Number Of Female Beneficiaries |
727 |
Number Of Male Beneficiaries |
532 |
Number Of Non Hispanic White Beneficiaries |
1074 |
Number Of Black or African American Beneficiaries |
91 |
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
22 |
Number Of Beneficiaries With Medicare Only Entitlement |
1138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
121 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0329 |