National Provider Identifier [NPI]: |
1326247966 |
Last Name Of The Provider |
PATEL |
First Name Of The Provider |
VEDVATI |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3023 N ASHLAND AVE |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606573144 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
157 |
Number Of Medicare Beneficiaries |
50 |
Total Submitted Charge Amount |
32786 |
Total Medicare Allowed Amount |
19270.22 |
Total Medicare Payment Amount |
15019.94 |
Total Medicare Standardized Payment Amount |
13991.78 |
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 |
13 |
Number Of Medical Services |
157 |
Number Of Medicare Beneficiaries With Medical Services |
50 |
Total Medical Submitted Charge Amount |
32786 |
Total Medical Medicare Allowed Amount |
19270.22 |
Total Medical Medicare Payment Amount |
15019.94 |
Total Medical Medicare Standardized Payment Amount |
13991.78 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
18 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
22 |
Number Of Male Beneficiaries |
28 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
28 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
3.2744 |