National Provider Identifier [NPI]: |
1861507824 |
Last Name Of The Provider |
GUPTA |
First Name Of The Provider |
VISHAL |
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 |
1717 SHAFFER ST |
Street Address 2 Of The Provider |
SUITE 232 |
City Of The Provider |
KALAMAZOO |
Zip Code Of The Provider |
490481647 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
4723 |
Number Of Medicare Beneficiaries |
2067 |
Total Submitted Charge Amount |
1093882 |
Total Medicare Allowed Amount |
382323.14 |
Total Medicare Payment Amount |
288410.23 |
Total Medicare Standardized Payment Amount |
297337.79 |
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 |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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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 |
324 |
Number Of Beneficiaries Age 65 to 74 |
753 |
Number Of Beneficiaries Age 75 to 84 |
680 |
Number Of Beneficiaries Age Greater 84 |
310 |
Number Of Female Beneficiaries |
1027 |
Number Of Male Beneficiaries |
1040 |
Number Of Non Hispanic White Beneficiaries |
1882 |
Number Of Black or African American Beneficiaries |
113 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
27 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
1667 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
400 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6601 |