National Provider Identifier [NPI]: |
1205034105 |
Last Name Of The Provider |
GUPTA |
First Name Of The Provider |
ADITYA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16001 W 9 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480754818 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
143 |
Number Of Services |
782 |
Number Of Medicare Beneficiaries |
206 |
Total Submitted Charge Amount |
633408.5 |
Total Medicare Allowed Amount |
136795.3 |
Total Medicare Payment Amount |
106446.06 |
Total Medicare Standardized Payment Amount |
116569.19 |
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 |
143 |
Number Of Medical Services |
782 |
Number Of Medicare Beneficiaries With Medical Services |
206 |
Total Medical Submitted Charge Amount |
633408.5 |
Total Medical Medicare Allowed Amount |
136795.3 |
Total Medical Medicare Payment Amount |
106446.06 |
Total Medical Medicare Standardized Payment Amount |
116569.19 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
187 |
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 |
160 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
27 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4598 |