National Provider Identifier [NPI]: |
1770874992 |
Last Name Of The Provider |
YELAVARTHI |
First Name Of The Provider |
DEEPTHI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2901 W KINNICKINNIC RIVER PKWY |
Street Address 2 Of The Provider |
SUITE 315 |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532153677 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
734 |
Number Of Medicare Beneficiaries |
266 |
Total Submitted Charge Amount |
208000 |
Total Medicare Allowed Amount |
70384.09 |
Total Medicare Payment Amount |
52583.07 |
Total Medicare Standardized Payment Amount |
56053.64 |
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 |
15 |
Number Of Medical Services |
734 |
Number Of Medicare Beneficiaries With Medical Services |
266 |
Total Medical Submitted Charge Amount |
208000 |
Total Medical Medicare Allowed Amount |
70384.09 |
Total Medical Medicare Payment Amount |
52583.07 |
Total Medical Medicare Standardized Payment Amount |
56053.64 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
205 |
Number Of Black or African American Beneficiaries |
43 |
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 |
173 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.9238 |