National Provider Identifier [NPI]: |
1699701060 |
Last Name Of The Provider |
SHENOY |
First Name Of The Provider |
VISHWANATH |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1815 MISSION 66 |
Street Address 2 Of The Provider |
|
City Of The Provider |
VICKSBURG |
Zip Code Of The Provider |
391803709 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
2591 |
Number Of Medicare Beneficiaries |
901 |
Total Submitted Charge Amount |
983651 |
Total Medicare Allowed Amount |
284071.15 |
Total Medicare Payment Amount |
215863.28 |
Total Medicare Standardized Payment Amount |
235849.64 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
191 |
Number Of Beneficiaries Age 65 to 74 |
354 |
Number Of Beneficiaries Age 75 to 84 |
240 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
528 |
Number Of Male Beneficiaries |
373 |
Number Of Non Hispanic White Beneficiaries |
508 |
Number Of Black or African American Beneficiaries |
380 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
578 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
323 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6146 |