National Provider Identifier [NPI]: |
1578772224 |
Last Name Of The Provider |
GHOSH |
First Name Of The Provider |
PRITAM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5323 HARRY HINES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
753907201 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
427 |
Number Of Medicare Beneficiaries |
286 |
Total Submitted Charge Amount |
110448 |
Total Medicare Allowed Amount |
54529.03 |
Total Medicare Payment Amount |
41943.39 |
Total Medicare Standardized Payment Amount |
43014.26 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
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 |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
157 |
Number Of Male Beneficiaries |
129 |
Number Of Non Hispanic White Beneficiaries |
244 |
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 |
186 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
49 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
71 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7461 |