National Provider Identifier [NPI]: |
1093933285 |
Last Name Of The Provider |
PATEL |
First Name Of The Provider |
NEAL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12303 DEPAUL DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
630442588 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
928 |
Number Of Medicare Beneficiaries |
629 |
Total Submitted Charge Amount |
1062582 |
Total Medicare Allowed Amount |
123208.63 |
Total Medicare Payment Amount |
94203.22 |
Total Medicare Standardized Payment Amount |
94816.69 |
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 |
28 |
Number Of Medical Services |
928 |
Number Of Medicare Beneficiaries With Medical Services |
629 |
Total Medical Submitted Charge Amount |
1062582 |
Total Medical Medicare Allowed Amount |
123208.63 |
Total Medical Medicare Payment Amount |
94203.22 |
Total Medical Medicare Standardized Payment Amount |
94816.69 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
202 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
364 |
Number Of Black or African American Beneficiaries |
|
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 |
344 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
285 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.6505 |