National Provider Identifier [NPI]: |
1902049364 |
Last Name Of The Provider |
GREWAL |
First Name Of The Provider |
NAVNEET |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2851 CR 210 STE. 122 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRUIT COVE |
Zip Code Of The Provider |
322594080 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
163 |
Number Of Medicare Beneficiaries |
68 |
Total Submitted Charge Amount |
44979.97 |
Total Medicare Allowed Amount |
15021.28 |
Total Medicare Payment Amount |
10850.82 |
Total Medicare Standardized Payment Amount |
11365.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
12 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
1440 |
Total Drug Medicare AllowedAmount |
515.39 |
Total Drug Medicare PaymentAmount |
487.43 |
Total Drug Medicare Standardized Payment Amount |
487.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
151 |
Number Of Medicare Beneficiaries With Medical Services |
67 |
Total Medical Submitted Charge Amount |
43539.97 |
Total Medical Medicare Allowed Amount |
14505.89 |
Total Medical Medicare Payment Amount |
10363.39 |
Total Medical Medicare Standardized Payment Amount |
10877.8 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
34 |
Number Of Male Beneficiaries |
34 |
Number Of Non Hispanic White Beneficiaries |
55 |
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 |
55 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
18 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7492 |