National Provider Identifier [NPI]: |
1619971553 |
Last Name Of The Provider |
CHOUDHARY |
First Name Of The Provider |
SMRITI |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
360 E MEDICAL CENTER BLVD |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
WEBSTER |
Zip Code Of The Provider |
775983121 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
2038 |
Number Of Medicare Beneficiaries |
409 |
Total Submitted Charge Amount |
251330.97 |
Total Medicare Allowed Amount |
170873.8 |
Total Medicare Payment Amount |
131599.45 |
Total Medicare Standardized Payment Amount |
132364.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
146 |
Number Of Medicare Beneficiaries With Drug Services |
114 |
Total Drug Submitted ChargeAmount |
3475 |
Total Drug Medicare AllowedAmount |
2336.87 |
Total Drug Medicare PaymentAmount |
2269.07 |
Total Drug Medicare Standardized Payment Amount |
2269.07 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
1892 |
Number Of Medicare Beneficiaries With Medical Services |
409 |
Total Medical Submitted Charge Amount |
247855.97 |
Total Medical Medicare Allowed Amount |
168536.93 |
Total Medical Medicare Payment Amount |
129330.38 |
Total Medical Medicare Standardized Payment Amount |
130095.56 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
150 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
227 |
Number Of Male Beneficiaries |
182 |
Number Of Non Hispanic White Beneficiaries |
327 |
Number Of Black or African American Beneficiaries |
42 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
355 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.2538 |