National Provider Identifier [NPI]: |
1003814146 |
Last Name Of The Provider |
PATEL |
First Name Of The Provider |
KETAN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9 MEDICAL PKWY |
Street Address 2 Of The Provider |
STE 308 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752347855 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
10065 |
Number Of Medicare Beneficiaries |
891 |
Total Submitted Charge Amount |
1782693 |
Total Medicare Allowed Amount |
892633.33 |
Total Medicare Payment Amount |
687162.9 |
Total Medicare Standardized Payment Amount |
701829.07 |
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 |
36 |
Number Of Medical Services |
10065 |
Number Of Medicare Beneficiaries With Medical Services |
891 |
Total Medical Submitted Charge Amount |
1782693 |
Total Medical Medicare Allowed Amount |
892633.33 |
Total Medical Medicare Payment Amount |
687162.9 |
Total Medical Medicare Standardized Payment Amount |
701829.07 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
258 |
Number Of Beneficiaries Age Greater 84 |
339 |
Number Of Female Beneficiaries |
569 |
Number Of Male Beneficiaries |
322 |
Number Of Non Hispanic White Beneficiaries |
685 |
Number Of Black or African American Beneficiaries |
79 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
80 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
593 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
298 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
54 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
71 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.4255 |