National Provider Identifier [NPI]: |
1154421063 |
Last Name Of The Provider |
TRIVEDI |
First Name Of The Provider |
SULOCHANA |
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 |
16453 COLORADO AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PARAMOUNT |
Zip Code Of The Provider |
907235011 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
948 |
Number Of Medicare Beneficiaries |
267 |
Total Submitted Charge Amount |
122436 |
Total Medicare Allowed Amount |
30154.29 |
Total Medicare Payment Amount |
23639.39 |
Total Medicare Standardized Payment Amount |
17379.21 |
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 |
12 |
Number Of Medical Services |
948 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
122436 |
Total Medical Medicare Allowed Amount |
30154.29 |
Total Medical Medicare Payment Amount |
23639.39 |
Total Medical Medicare Standardized Payment Amount |
17379.21 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
154 |
Number Of Non Hispanic White Beneficiaries |
95 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
89 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
47 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
220 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
63 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
72 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
43 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
5.3446 |