National Provider Identifier [NPI]: |
1598747289 |
Last Name Of The Provider |
SHIRODKAR |
First Name Of The Provider |
PRADEEP |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11937 US HIGHWAY 271 |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757083154 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1702 |
Number Of Medicare Beneficiaries |
491 |
Total Submitted Charge Amount |
321871.5 |
Total Medicare Allowed Amount |
157089.54 |
Total Medicare Payment Amount |
122222.65 |
Total Medicare Standardized Payment Amount |
126519.44 |
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 |
15 |
Number Of Medical Services |
1702 |
Number Of Medicare Beneficiaries With Medical Services |
491 |
Total Medical Submitted Charge Amount |
321871.5 |
Total Medical Medicare Allowed Amount |
157089.54 |
Total Medical Medicare Payment Amount |
122222.65 |
Total Medical Medicare Standardized Payment Amount |
126519.44 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
117 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
254 |
Number Of Male Beneficiaries |
237 |
Number Of Non Hispanic White Beneficiaries |
380 |
Number Of Black or African American Beneficiaries |
87 |
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 |
300 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
191 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.8014 |