National Provider Identifier [NPI]: |
1982651337 |
Last Name Of The Provider |
THATTE |
First Name Of The Provider |
LALITA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3300 TAMIAMI TRAIL |
Street Address 2 Of The Provider |
SUITE 101A |
City Of The Provider |
PORT CHARLOTTE |
Zip Code Of The Provider |
339528054 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
3001 |
Number Of Medicare Beneficiaries |
625 |
Total Submitted Charge Amount |
551097.62 |
Total Medicare Allowed Amount |
456541.27 |
Total Medicare Payment Amount |
346468.53 |
Total Medicare Standardized Payment Amount |
344719.83 |
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 |
16 |
Number Of Medical Services |
3001 |
Number Of Medicare Beneficiaries With Medical Services |
625 |
Total Medical Submitted Charge Amount |
551097.62 |
Total Medical Medicare Allowed Amount |
456541.27 |
Total Medical Medicare Payment Amount |
346468.53 |
Total Medical Medicare Standardized Payment Amount |
344719.83 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
174 |
Number Of Beneficiaries Age 75 to 84 |
218 |
Number Of Beneficiaries Age Greater 84 |
117 |
Number Of Female Beneficiaries |
279 |
Number Of Male Beneficiaries |
346 |
Number Of Non Hispanic White Beneficiaries |
520 |
Number Of Black or African American Beneficiaries |
62 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
460 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
165 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
3.7978 |