National Provider Identifier [NPI]: |
1699823609 |
Last Name Of The Provider |
GHELANI |
First Name Of The Provider |
JIGAR |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
227 W JANSS RD |
Street Address 2 Of The Provider |
SUITE 110 |
City Of The Provider |
THOUSAND OAKS |
Zip Code Of The Provider |
913601848 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
13547 |
Number Of Medicare Beneficiaries |
818 |
Total Submitted Charge Amount |
1667926.08 |
Total Medicare Allowed Amount |
567262.74 |
Total Medicare Payment Amount |
435092.13 |
Total Medicare Standardized Payment Amount |
404654.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
8101 |
Number Of Medicare Beneficiaries With Drug Services |
252 |
Total Drug Submitted ChargeAmount |
111750.8 |
Total Drug Medicare AllowedAmount |
36758.61 |
Total Drug Medicare PaymentAmount |
29711.79 |
Total Drug Medicare Standardized Payment Amount |
29711.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
5446 |
Number Of Medicare Beneficiaries With Medical Services |
818 |
Total Medical Submitted Charge Amount |
1556175.28 |
Total Medical Medicare Allowed Amount |
530504.13 |
Total Medical Medicare Payment Amount |
405380.34 |
Total Medical Medicare Standardized Payment Amount |
374942.28 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
295 |
Number Of Beneficiaries Age 75 to 84 |
293 |
Number Of Beneficiaries Age Greater 84 |
210 |
Number Of Female Beneficiaries |
444 |
Number Of Male Beneficiaries |
374 |
Number Of Non Hispanic White Beneficiaries |
755 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
793 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4925 |