National Provider Identifier [NPI]: |
1295765568 |
Last Name Of The Provider |
MEWAR |
First Name Of The Provider |
MANAS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3600 GASTON AVE |
Street Address 2 Of The Provider |
#550 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752461800 |
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 |
15 |
Number Of Services |
995 |
Number Of Medicare Beneficiaries |
464 |
Total Submitted Charge Amount |
400861 |
Total Medicare Allowed Amount |
90818.45 |
Total Medicare Payment Amount |
70853.16 |
Total Medicare Standardized Payment Amount |
70869.6 |
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 |
15 |
Number Of Medical Services |
995 |
Number Of Medicare Beneficiaries With Medical Services |
464 |
Total Medical Submitted Charge Amount |
400861 |
Total Medical Medicare Allowed Amount |
90818.45 |
Total Medical Medicare Payment Amount |
70853.16 |
Total Medical Medicare Standardized Payment Amount |
70869.6 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
164 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
265 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
209 |
Number Of Black or African American Beneficiaries |
192 |
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 |
216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
248 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
73 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
3.0398 |