| National Provider Identifier [NPI]: | 1760426050 |
| Last Name Of The Provider | GHELANI |
| First Name Of The Provider | DIPAK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3288 MOANALUA RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HONOLULU |
| Zip Code Of The Provider | 968191469 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 2175 |
| Number Of Medicare Beneficiaries | 28 |
| Total Submitted Charge Amount | 116784.05 |
| Total Medicare Allowed Amount | 40099.39 |
| Total Medicare Payment Amount | 30165.54 |
| Total Medicare Standardized Payment Amount | 30415.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 2076 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 101285.45 |
| Total Drug Medicare AllowedAmount | 31318.88 |
| Total Drug Medicare PaymentAmount | 24457.28 |
| Total Drug Medicare Standardized Payment Amount | 24457.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 99 |
| Number Of Medicare Beneficiaries With Medical Services | 25 |
| Total Medical Submitted Charge Amount | 15498.6 |
| Total Medical Medicare Allowed Amount | 8780.51 |
| Total Medical Medicare Payment Amount | 5708.26 |
| Total Medical Medicare Standardized Payment Amount | 5958.68 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 14 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | 12 |
| Number Of Black or African American Beneficiaries | |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 64 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.9238 |