| National Provider Identifier [NPI]: | 1487655957 |
| Last Name Of The Provider | SRIVASTAVA |
| First Name Of The Provider | PANKAJ |
| 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 | 1445 US HIGHWAY 51 BYP E |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | DYERSBURG |
| Zip Code Of The Provider | 380242127 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 33306.5 |
| Number Of Medicare Beneficiaries | 1259 |
| Total Submitted Charge Amount | 2914063 |
| Total Medicare Allowed Amount | 1342442.71 |
| Total Medicare Payment Amount | 1049814.49 |
| Total Medicare Standardized Payment Amount | 1120614.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 4796.5 |
| Number Of Medicare Beneficiaries With Drug Services | 592 |
| Total Drug Submitted ChargeAmount | 83580 |
| Total Drug Medicare AllowedAmount | 21611.06 |
| Total Drug Medicare PaymentAmount | 20589.79 |
| Total Drug Medicare Standardized Payment Amount | 20589.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 145 |
| Number Of Medical Services | 28510 |
| Number Of Medicare Beneficiaries With Medical Services | 1259 |
| Total Medical Submitted Charge Amount | 2830483 |
| Total Medical Medicare Allowed Amount | 1320831.65 |
| Total Medical Medicare Payment Amount | 1029224.7 |
| Total Medical Medicare Standardized Payment Amount | 1100024.31 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 572 |
| Number Of Beneficiaries Age 65 to 74 | 371 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 780 |
| Number Of Male Beneficiaries | 479 |
| Number Of Non Hispanic White Beneficiaries | 962 |
| Number Of Black or African American Beneficiaries | 279 |
| 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 | 462 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 797 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.68 |