National Provider Identifier [NPI]: |
1477757961 |
Last Name Of The Provider |
UPPAL |
First Name Of The Provider |
DUSHANT |
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 |
LEE ST FL 1 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHARLOTTESVILLE |
Zip Code Of The Provider |
229080001 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
258 |
Number Of Medicare Beneficiaries |
173 |
Total Submitted Charge Amount |
148622 |
Total Medicare Allowed Amount |
34923.07 |
Total Medicare Payment Amount |
27570.47 |
Total Medicare Standardized Payment Amount |
28711.35 |
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 |
31 |
Number Of Medical Services |
258 |
Number Of Medicare Beneficiaries With Medical Services |
173 |
Total Medical Submitted Charge Amount |
148622 |
Total Medical Medicare Allowed Amount |
34923.07 |
Total Medical Medicare Payment Amount |
27570.47 |
Total Medical Medicare Standardized Payment Amount |
28711.35 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
137 |
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 |
121 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.0625 |