National Provider Identifier [NPI]: |
1639122666 |
Last Name Of The Provider |
TRIVEDI |
First Name Of The Provider |
JAYA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5323 HARRY HINES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
753907208 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
850 |
Number Of Medicare Beneficiaries |
406 |
Total Submitted Charge Amount |
229386 |
Total Medicare Allowed Amount |
84672.57 |
Total Medicare Payment Amount |
62776.98 |
Total Medicare Standardized Payment Amount |
60365.02 |
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 |
37 |
Number Of Medical Services |
850 |
Number Of Medicare Beneficiaries With Medical Services |
406 |
Total Medical Submitted Charge Amount |
229386 |
Total Medical Medicare Allowed Amount |
84672.57 |
Total Medical Medicare Payment Amount |
62776.98 |
Total Medical Medicare Standardized Payment Amount |
60365.02 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
173 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
211 |
Number Of Non Hispanic White Beneficiaries |
309 |
Number Of Black or African American Beneficiaries |
58 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
341 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6215 |