National Provider Identifier [NPI]: |
1568646776 |
Last Name Of The Provider |
BANSAL |
First Name Of The Provider |
ALOK |
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 |
2485 HOSPITAL DR |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
MOUNTAIN VIEW |
Zip Code Of The Provider |
940404101 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
5243 |
Number Of Medicare Beneficiaries |
576 |
Total Submitted Charge Amount |
1317415 |
Total Medicare Allowed Amount |
928232.58 |
Total Medicare Payment Amount |
710401.44 |
Total Medicare Standardized Payment Amount |
653236.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
984 |
Number Of Medicare Beneficiaries With Drug Services |
58 |
Total Drug Submitted ChargeAmount |
476396 |
Total Drug Medicare AllowedAmount |
455912.55 |
Total Drug Medicare PaymentAmount |
355184.21 |
Total Drug Medicare Standardized Payment Amount |
355184.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
4259 |
Number Of Medicare Beneficiaries With Medical Services |
574 |
Total Medical Submitted Charge Amount |
841019 |
Total Medical Medicare Allowed Amount |
472320.03 |
Total Medical Medicare Payment Amount |
355217.23 |
Total Medical Medicare Standardized Payment Amount |
298052.57 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
202 |
Number Of Beneficiaries Age 75 to 84 |
209 |
Number Of Beneficiaries Age Greater 84 |
143 |
Number Of Female Beneficiaries |
335 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
375 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
91 |
Number Of Hispanic Beneficiaries |
75 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
457 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3917 |