National Provider Identifier [NPI]: |
1487942124 |
Last Name Of The Provider |
PARVATANENI |
First Name Of The Provider |
KESAV |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22201 MOROSS RD |
Street Address 2 Of The Provider |
PB2 SUITE 50 |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482362169 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
316 |
Number Of Medicare Beneficiaries |
157 |
Total Submitted Charge Amount |
39952.7 |
Total Medicare Allowed Amount |
29453.78 |
Total Medicare Payment Amount |
22899.59 |
Total Medicare Standardized Payment Amount |
21398.59 |
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 |
17 |
Number Of Medical Services |
316 |
Number Of Medicare Beneficiaries With Medical Services |
157 |
Total Medical Submitted Charge Amount |
39952.7 |
Total Medical Medicare Allowed Amount |
29453.78 |
Total Medical Medicare Payment Amount |
22899.59 |
Total Medical Medicare Standardized Payment Amount |
21398.59 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
104 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.642 |