National Provider Identifier [NPI]: |
1639279540 |
Last Name Of The Provider |
MENDIRATTA |
First Name Of The Provider |
PRIYA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4301 W MARKHAM ST |
Street Address 2 Of The Provider |
UAMS #783 |
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722057101 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Geriatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1291 |
Number Of Medicare Beneficiaries |
558 |
Total Submitted Charge Amount |
211089 |
Total Medicare Allowed Amount |
104216.95 |
Total Medicare Payment Amount |
74737.09 |
Total Medicare Standardized Payment Amount |
80737.99 |
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 |
25 |
Number Of Medical Services |
1291 |
Number Of Medicare Beneficiaries With Medical Services |
558 |
Total Medical Submitted Charge Amount |
211089 |
Total Medical Medicare Allowed Amount |
104216.95 |
Total Medical Medicare Payment Amount |
74737.09 |
Total Medical Medicare Standardized Payment Amount |
80737.99 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
168 |
Number Of Beneficiaries Age 75 to 84 |
213 |
Number Of Beneficiaries Age Greater 84 |
147 |
Number Of Female Beneficiaries |
401 |
Number Of Male Beneficiaries |
157 |
Number Of Non Hispanic White Beneficiaries |
451 |
Number Of Black or African American Beneficiaries |
95 |
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 |
411 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
27 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.6025 |