National Provider Identifier [NPI]: |
1194902742 |
Last Name Of The Provider |
PATEL |
First Name Of The Provider |
SHETAL |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2292 PEACHTREE ROAD NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
30309 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
169 |
Number Of Medicare Beneficiaries |
36 |
Total Submitted Charge Amount |
17545 |
Total Medicare Allowed Amount |
6094.64 |
Total Medicare Payment Amount |
5241.4 |
Total Medicare Standardized Payment Amount |
5225.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
18 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
843 |
Total Drug Medicare AllowedAmount |
457.21 |
Total Drug Medicare PaymentAmount |
448.01 |
Total Drug Medicare Standardized Payment Amount |
448.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
151 |
Number Of Medicare Beneficiaries With Medical Services |
36 |
Total Medical Submitted Charge Amount |
16702 |
Total Medical Medicare Allowed Amount |
5637.43 |
Total Medical Medicare Payment Amount |
4793.39 |
Total Medical Medicare Standardized Payment Amount |
4777.22 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
23 |
Number Of Male Beneficiaries |
13 |
Number Of Non Hispanic White Beneficiaries |
25 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
0 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
0 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
0 |
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
31 |
Percent Of With Hypertension |
42 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8064 |