National Provider Identifier [NPI]: |
1528216546 |
Last Name Of The Provider |
GUPTA |
First Name Of The Provider |
SHILPA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6245 INKSTER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GARDEN CITY |
Zip Code Of The Provider |
481354001 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
661 |
Number Of Medicare Beneficiaries |
577 |
Total Submitted Charge Amount |
330138 |
Total Medicare Allowed Amount |
94789.56 |
Total Medicare Payment Amount |
72866.18 |
Total Medicare Standardized Payment Amount |
72207.93 |
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 |
26 |
Number Of Medical Services |
661 |
Number Of Medicare Beneficiaries With Medical Services |
577 |
Total Medical Submitted Charge Amount |
330138 |
Total Medical Medicare Allowed Amount |
94789.56 |
Total Medical Medicare Payment Amount |
72866.18 |
Total Medical Medicare Standardized Payment Amount |
72207.93 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
130 |
Number Of Beneficiaries Age 65 to 74 |
190 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
131 |
Number Of Female Beneficiaries |
311 |
Number Of Male Beneficiaries |
266 |
Number Of Non Hispanic White Beneficiaries |
487 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
57 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
379 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
198 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6654 |