National Provider Identifier [NPI]: |
1003886565 |
Last Name Of The Provider |
GUPTA |
First Name Of The Provider |
ASHOK |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 E SPICERVILLE HWY |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
EATON RAPIDS |
Zip Code Of The Provider |
488271919 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
2573 |
Number Of Medicare Beneficiaries |
696 |
Total Submitted Charge Amount |
374527 |
Total Medicare Allowed Amount |
224044.68 |
Total Medicare Payment Amount |
166107.13 |
Total Medicare Standardized Payment Amount |
173951.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
154 |
Number Of Medicare Beneficiaries With Drug Services |
135 |
Total Drug Submitted ChargeAmount |
4440 |
Total Drug Medicare AllowedAmount |
3324.06 |
Total Drug Medicare PaymentAmount |
3238.53 |
Total Drug Medicare Standardized Payment Amount |
3238.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
2419 |
Number Of Medicare Beneficiaries With Medical Services |
696 |
Total Medical Submitted Charge Amount |
370087 |
Total Medical Medicare Allowed Amount |
220720.62 |
Total Medical Medicare Payment Amount |
162868.6 |
Total Medical Medicare Standardized Payment Amount |
170713.25 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
138 |
Number Of Beneficiaries Age 65 to 74 |
316 |
Number Of Beneficiaries Age 75 to 84 |
169 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
325 |
Number Of Male Beneficiaries |
371 |
Number Of Non Hispanic White Beneficiaries |
655 |
Number Of Black or African American Beneficiaries |
19 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
577 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1556 |