| National Provider Identifier [NPI]: | 1750398020 |
| Last Name Of The Provider | JAIN |
| First Name Of The Provider | VIVEK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2734 EL CAMINO REAL |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA CLARA |
| Zip Code Of The Provider | 950513007 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 318 |
| Number Of Medicare Beneficiaries | 84 |
| Total Submitted Charge Amount | 74341 |
| Total Medicare Allowed Amount | 33495.52 |
| Total Medicare Payment Amount | 23800.19 |
| Total Medicare Standardized Payment Amount | 20207.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1533 |
| Total Drug Medicare AllowedAmount | 885.86 |
| Total Drug Medicare PaymentAmount | 867.17 |
| Total Drug Medicare Standardized Payment Amount | 867.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 289 |
| Number Of Medicare Beneficiaries With Medical Services | 84 |
| Total Medical Submitted Charge Amount | 72808 |
| Total Medical Medicare Allowed Amount | 32609.66 |
| Total Medical Medicare Payment Amount | 22933.02 |
| Total Medical Medicare Standardized Payment Amount | 19339.95 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 42 |
| Number Of Male Beneficiaries | 42 |
| Number Of Non Hispanic White Beneficiaries | 36 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| 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 | 68 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 18 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9207 |