National Provider Identifier [NPI]: |
1497062087 |
Last Name Of The Provider |
GUPTA |
First Name Of The Provider |
SACHI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.B.B.S. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
619 19TH ST S |
Street Address 2 Of The Provider |
|
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
352491900 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1308 |
Number Of Medicare Beneficiaries |
392 |
Total Submitted Charge Amount |
283030.83 |
Total Medicare Allowed Amount |
116949.27 |
Total Medicare Payment Amount |
91273 |
Total Medicare Standardized Payment Amount |
96572.62 |
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 |
17 |
Number Of Medical Services |
1308 |
Number Of Medicare Beneficiaries With Medical Services |
392 |
Total Medical Submitted Charge Amount |
283030.83 |
Total Medical Medicare Allowed Amount |
116949.27 |
Total Medical Medicare Payment Amount |
91273 |
Total Medical Medicare Standardized Payment Amount |
96572.62 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
162 |
Number Of Non Hispanic White Beneficiaries |
328 |
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 |
293 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.8906 |