| National Provider Identifier [NPI]: | 1962401471 |
| Last Name Of The Provider | GINCHANSKY |
| First Name Of The Provider | ELLIOT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7777 FOREST LN |
| Street Address 2 Of The Provider | SUITE C530 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752302505 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 3381 |
| Number Of Medicare Beneficiaries | 112 |
| Total Submitted Charge Amount | 77965.42 |
| Total Medicare Allowed Amount | 72043.64 |
| Total Medicare Payment Amount | 54218.71 |
| Total Medicare Standardized Payment Amount | 52304.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1673 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 42840.97 |
| Total Drug Medicare AllowedAmount | 41913.82 |
| Total Drug Medicare PaymentAmount | 32962.83 |
| Total Drug Medicare Standardized Payment Amount | 32962.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 1708 |
| Number Of Medicare Beneficiaries With Medical Services | 111 |
| Total Medical Submitted Charge Amount | 35124.45 |
| Total Medical Medicare Allowed Amount | 30129.82 |
| Total Medical Medicare Payment Amount | 21255.88 |
| Total Medical Medicare Standardized Payment Amount | 19341.42 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 84 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 70 |
| Number Of Male Beneficiaries | 42 |
| Number Of Non Hispanic White Beneficiaries | 99 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 36 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6958 |