National Provider Identifier [NPI]: |
1225045735 |
Last Name Of The Provider |
MEHTA |
First Name Of The Provider |
NILESH |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6065 MONTANA AVE |
Street Address 2 Of The Provider |
STE C10 |
City Of The Provider |
EL PASO |
Zip Code Of The Provider |
799251835 |
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 |
30 |
Number Of Services |
3243 |
Number Of Medicare Beneficiaries |
562 |
Total Submitted Charge Amount |
423970 |
Total Medicare Allowed Amount |
244546.78 |
Total Medicare Payment Amount |
175086.41 |
Total Medicare Standardized Payment Amount |
184385.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
51 |
Number Of Medicare Beneficiaries With Drug Services |
51 |
Total Drug Submitted ChargeAmount |
2305 |
Total Drug Medicare AllowedAmount |
720.93 |
Total Drug Medicare PaymentAmount |
699.89 |
Total Drug Medicare Standardized Payment Amount |
699.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
3192 |
Number Of Medicare Beneficiaries With Medical Services |
562 |
Total Medical Submitted Charge Amount |
421665 |
Total Medical Medicare Allowed Amount |
243825.85 |
Total Medical Medicare Payment Amount |
174386.52 |
Total Medical Medicare Standardized Payment Amount |
183685.19 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
219 |
Number Of Beneficiaries Age 75 to 84 |
191 |
Number Of Beneficiaries Age Greater 84 |
94 |
Number Of Female Beneficiaries |
329 |
Number Of Male Beneficiaries |
233 |
Number Of Non Hispanic White Beneficiaries |
158 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
16 |
Number Of Hispanic Beneficiaries |
375 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
377 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
185 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.5468 |