| National Provider Identifier [NPI]: | 1568576999 |
| Last Name Of The Provider | TRIVIKRAM |
| First Name Of The Provider | LALITHA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 750 W LINCOLN HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | EXTON |
| Zip Code Of The Provider | 193412547 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 601 |
| Number Of Medicare Beneficiaries | 244 |
| Total Submitted Charge Amount | 60430 |
| Total Medicare Allowed Amount | 49854.05 |
| Total Medicare Payment Amount | 36189.23 |
| Total Medicare Standardized Payment Amount | 34296.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 2185 |
| Total Drug Medicare AllowedAmount | 1601.55 |
| Total Drug Medicare PaymentAmount | 1566.69 |
| Total Drug Medicare Standardized Payment Amount | 1566.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 555 |
| Number Of Medicare Beneficiaries With Medical Services | 244 |
| Total Medical Submitted Charge Amount | 58245 |
| Total Medical Medicare Allowed Amount | 48252.5 |
| Total Medical Medicare Payment Amount | 34622.54 |
| Total Medical Medicare Standardized Payment Amount | 32730.08 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 175 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 224 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 223 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9824 |