National Provider Identifier [NPI]: |
1356540330 |
Last Name Of The Provider |
MADADI |
First Name Of The Provider |
SHILPA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1617 HEMPHILL ST |
Street Address 2 Of The Provider |
DEPARTMENT OF INTERNAL MEDICINE |
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761044709 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
289 |
Number Of Medicare Beneficiaries |
156 |
Total Submitted Charge Amount |
98786.62 |
Total Medicare Allowed Amount |
42948.42 |
Total Medicare Payment Amount |
33535.29 |
Total Medicare Standardized Payment Amount |
34621.91 |
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 |
31 |
Number Of Medical Services |
289 |
Number Of Medicare Beneficiaries With Medical Services |
156 |
Total Medical Submitted Charge Amount |
98786.62 |
Total Medical Medicare Allowed Amount |
42948.42 |
Total Medical Medicare Payment Amount |
33535.29 |
Total Medical Medicare Standardized Payment Amount |
34621.91 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
83 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
49 |
Number Of Black or African American Beneficiaries |
63 |
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 |
62 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6902 |