| National Provider Identifier [NPI]: | 1992013015 |
| Last Name Of The Provider | VIVEKANANTHAN |
| First Name Of The Provider | GAITHRI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | P.A.-C. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6124 W PARKER RD |
| Street Address 2 Of The Provider | SUITE 530 |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 750938122 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 198 |
| Number Of Medicare Beneficiaries | 113 |
| Total Submitted Charge Amount | 35795 |
| Total Medicare Allowed Amount | 13063.03 |
| Total Medicare Payment Amount | 9945.78 |
| Total Medicare Standardized Payment Amount | 12003.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 424 |
| Total Drug Medicare AllowedAmount | 111.52 |
| Total Drug Medicare PaymentAmount | 89.37 |
| Total Drug Medicare Standardized Payment Amount | 89.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 173 |
| Number Of Medicare Beneficiaries With Medical Services | 113 |
| Total Medical Submitted Charge Amount | 35371 |
| Total Medical Medicare Allowed Amount | 12951.51 |
| Total Medical Medicare Payment Amount | 9856.41 |
| Total Medical Medicare Standardized Payment Amount | 11914.56 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 63 |
| Number Of Male Beneficiaries | 50 |
| Number Of Non Hispanic White Beneficiaries | 91 |
| Number Of Black or African American Beneficiaries | |
| 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 | 98 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3197 |