National Provider Identifier [NPI]: |
1477583797 |
Last Name Of The Provider |
VAID |
First Name Of The Provider |
BRIJ |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13065 OLD TESSON FERRY ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
63128 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
5437 |
Number Of Medicare Beneficiaries |
822 |
Total Submitted Charge Amount |
967021.69 |
Total Medicare Allowed Amount |
499107.03 |
Total Medicare Payment Amount |
358754.61 |
Total Medicare Standardized Payment Amount |
375196.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
1955 |
Total Drug Medicare AllowedAmount |
481.51 |
Total Drug Medicare PaymentAmount |
441.24 |
Total Drug Medicare Standardized Payment Amount |
441.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
68 |
Number Of Medical Services |
5385 |
Number Of Medicare Beneficiaries With Medical Services |
821 |
Total Medical Submitted Charge Amount |
965066.69 |
Total Medical Medicare Allowed Amount |
498625.52 |
Total Medical Medicare Payment Amount |
358313.37 |
Total Medical Medicare Standardized Payment Amount |
374755.46 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
433 |
Number Of Beneficiaries Age 65 to 74 |
237 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
462 |
Number Of Male Beneficiaries |
360 |
Number Of Non Hispanic White Beneficiaries |
664 |
Number Of Black or African American Beneficiaries |
124 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
469 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
353 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
64 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6977 |