| National Provider Identifier [NPI]: | 1174535033 |
| Last Name Of The Provider | GOPALANI |
| First Name Of The Provider | ANISA |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 133 MEDICAL PARK LN |
| Street Address 2 Of The Provider | STE B |
| City Of The Provider | HUNTSVILLE |
| Zip Code Of The Provider | 773404979 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 27060 |
| Number Of Medicare Beneficiaries | 408 |
| Total Submitted Charge Amount | 3913062.73 |
| Total Medicare Allowed Amount | 761060.01 |
| Total Medicare Payment Amount | 622006.99 |
| Total Medicare Standardized Payment Amount | 533422.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 12762 |
| Number Of Medicare Beneficiaries With Drug Services | 306 |
| Total Drug Submitted ChargeAmount | 77323.28 |
| Total Drug Medicare AllowedAmount | 15940.6 |
| Total Drug Medicare PaymentAmount | 12381.17 |
| Total Drug Medicare Standardized Payment Amount | 12381.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 14298 |
| Number Of Medicare Beneficiaries With Medical Services | 408 |
| Total Medical Submitted Charge Amount | 3835739.45 |
| Total Medical Medicare Allowed Amount | 745119.41 |
| Total Medical Medicare Payment Amount | 609625.82 |
| Total Medical Medicare Standardized Payment Amount | 521041.02 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 269 |
| Number Of Male Beneficiaries | 139 |
| Number Of Non Hispanic White Beneficiaries | 375 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 313 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5158 |