National Provider Identifier [NPI]: |
1407819683 |
Last Name Of The Provider |
PATEL |
First Name Of The Provider |
ALPA |
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 |
6484 FORT CAROLINE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322772042 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
145 |
Number Of Services |
13216 |
Number Of Medicare Beneficiaries |
839 |
Total Submitted Charge Amount |
933257 |
Total Medicare Allowed Amount |
404654 |
Total Medicare Payment Amount |
318036 |
Total Medicare Standardized Payment Amount |
324113.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
25 |
Number Of Drug Services |
1679 |
Number Of Medicare Beneficiaries With Drug Services |
329 |
Total Drug Submitted ChargeAmount |
48305 |
Total Drug Medicare AllowedAmount |
29531.43 |
Total Drug Medicare PaymentAmount |
25643.67 |
Total Drug Medicare Standardized Payment Amount |
25643.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
120 |
Number Of Medical Services |
11537 |
Number Of Medicare Beneficiaries With Medical Services |
839 |
Total Medical Submitted Charge Amount |
884952 |
Total Medical Medicare Allowed Amount |
375122.57 |
Total Medical Medicare Payment Amount |
292392.33 |
Total Medical Medicare Standardized Payment Amount |
298470.26 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
139 |
Number Of Beneficiaries Age 65 to 74 |
405 |
Number Of Beneficiaries Age 75 to 84 |
206 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
582 |
Number Of Male Beneficiaries |
257 |
Number Of Non Hispanic White Beneficiaries |
585 |
Number Of Black or African American Beneficiaries |
153 |
Number Of AsianPacific Islander Beneficiaries |
54 |
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 |
683 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2801 |