| National Provider Identifier [NPI]: | 1548455694 |
| Last Name Of The Provider | SRIVASTAVA |
| First Name Of The Provider | MUKTA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22 S GREENE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212011544 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 2131 |
| Number Of Medicare Beneficiaries | 1328 |
| Total Submitted Charge Amount | 549755 |
| Total Medicare Allowed Amount | 179677.76 |
| Total Medicare Payment Amount | 137835.37 |
| Total Medicare Standardized Payment Amount | 129447.84 |
| 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 | 56 |
| Number Of Medical Services | 2131 |
| Number Of Medicare Beneficiaries With Medical Services | 1328 |
| Total Medical Submitted Charge Amount | 549755 |
| Total Medical Medicare Allowed Amount | 179677.76 |
| Total Medical Medicare Payment Amount | 137835.37 |
| Total Medical Medicare Standardized Payment Amount | 129447.84 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 358 |
| Number Of Beneficiaries Age 65 to 74 | 505 |
| Number Of Beneficiaries Age 75 to 84 | 331 |
| Number Of Beneficiaries Age Greater 84 | 134 |
| Number Of Female Beneficiaries | 659 |
| Number Of Male Beneficiaries | 669 |
| Number Of Non Hispanic White Beneficiaries | 835 |
| Number Of Black or African American Beneficiaries | 440 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 978 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 350 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.3924 |