National Provider Identifier [NPI]: |
1104938802 |
Last Name Of The Provider |
PATEL |
First Name Of The Provider |
AMBARISH |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
69 BERLIN RD |
Street Address 2 Of The Provider |
STE 1 |
City Of The Provider |
CHERRY HILL |
Zip Code Of The Provider |
08034 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
4651 |
Number Of Medicare Beneficiaries |
888 |
Total Submitted Charge Amount |
412981.45 |
Total Medicare Allowed Amount |
337810.04 |
Total Medicare Payment Amount |
267585.74 |
Total Medicare Standardized Payment Amount |
251917.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
773 |
Number Of Medicare Beneficiaries With Drug Services |
559 |
Total Drug Submitted ChargeAmount |
33416.98 |
Total Drug Medicare AllowedAmount |
22831.63 |
Total Drug Medicare PaymentAmount |
22300.27 |
Total Drug Medicare Standardized Payment Amount |
22300.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
3878 |
Number Of Medicare Beneficiaries With Medical Services |
888 |
Total Medical Submitted Charge Amount |
379564.47 |
Total Medical Medicare Allowed Amount |
314978.41 |
Total Medical Medicare Payment Amount |
245285.47 |
Total Medical Medicare Standardized Payment Amount |
229616.92 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
487 |
Number Of Beneficiaries Age 75 to 84 |
214 |
Number Of Beneficiaries Age Greater 84 |
122 |
Number Of Female Beneficiaries |
501 |
Number Of Male Beneficiaries |
387 |
Number Of Non Hispanic White Beneficiaries |
752 |
Number Of Black or African American Beneficiaries |
44 |
Number Of AsianPacific Islander Beneficiaries |
54 |
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
808 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9869 |