National Provider Identifier [NPI]: |
1134298938 |
Last Name Of The Provider |
GANDA |
First Name Of The Provider |
OM |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 JOSLIN PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
022155306 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
3437 |
Number Of Medicare Beneficiaries |
342 |
Total Submitted Charge Amount |
297739 |
Total Medicare Allowed Amount |
94298.36 |
Total Medicare Payment Amount |
70064.41 |
Total Medicare Standardized Payment Amount |
68502.16 |
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 |
48 |
Number Of Medical Services |
3437 |
Number Of Medicare Beneficiaries With Medical Services |
342 |
Total Medical Submitted Charge Amount |
297739 |
Total Medical Medicare Allowed Amount |
94298.36 |
Total Medical Medicare Payment Amount |
70064.41 |
Total Medical Medicare Standardized Payment Amount |
68502.16 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
90 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
193 |
Number Of Non Hispanic White Beneficiaries |
270 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
245 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.0072 |