National Provider Identifier [NPI]: |
1205883790 |
Last Name Of The Provider |
MISRA |
First Name Of The Provider |
BISMRUTA |
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 |
292 LONG RIDGE RD |
Street Address 2 Of The Provider |
SUITE 206 |
City Of The Provider |
STAMFORD |
Zip Code Of The Provider |
069021627 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
865 |
Number Of Medicare Beneficiaries |
246 |
Total Submitted Charge Amount |
168385.01 |
Total Medicare Allowed Amount |
81553.43 |
Total Medicare Payment Amount |
60299.13 |
Total Medicare Standardized Payment Amount |
56482.02 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
160 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
190 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
29 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
1.6427 |