National Provider Identifier [NPI]: |
1619945656 |
Last Name Of The Provider |
SRIVASTAVA |
First Name Of The Provider |
MOHIT |
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 |
109 N LEXINGTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BUNKIE |
Zip Code Of The Provider |
713221619 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
1603 |
Number Of Medicare Beneficiaries |
421 |
Total Submitted Charge Amount |
204975.94 |
Total Medicare Allowed Amount |
115426.93 |
Total Medicare Payment Amount |
86934.83 |
Total Medicare Standardized Payment Amount |
90917.55 |
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 |
38 |
Number Of Medical Services |
1603 |
Number Of Medicare Beneficiaries With Medical Services |
421 |
Total Medical Submitted Charge Amount |
204975.94 |
Total Medical Medicare Allowed Amount |
115426.93 |
Total Medical Medicare Payment Amount |
86934.83 |
Total Medical Medicare Standardized Payment Amount |
90917.55 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
236 |
Number Of Male Beneficiaries |
185 |
Number Of Non Hispanic White Beneficiaries |
261 |
Number Of Black or African American Beneficiaries |
143 |
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 |
142 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
279 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.1373 |