| National Provider Identifier [NPI]: | 1346248135 |
| Last Name Of The Provider | JASTI |
| First Name Of The Provider | KISHAN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 25195 KELLY ROAD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | ROSEVILLE |
| Zip Code Of The Provider | 480664909 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 6078 |
| Number Of Medicare Beneficiaries | 2462 |
| Total Submitted Charge Amount | 891417 |
| Total Medicare Allowed Amount | 402261.92 |
| Total Medicare Payment Amount | 310339.76 |
| Total Medicare Standardized Payment Amount | 303431.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 218 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 10280 |
| Total Drug Medicare AllowedAmount | 4994.09 |
| Total Drug Medicare PaymentAmount | 3852.81 |
| Total Drug Medicare Standardized Payment Amount | 3852.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 5860 |
| Number Of Medicare Beneficiaries With Medical Services | 2462 |
| Total Medical Submitted Charge Amount | 881137 |
| Total Medical Medicare Allowed Amount | 397267.83 |
| Total Medical Medicare Payment Amount | 306486.95 |
| Total Medical Medicare Standardized Payment Amount | 299578.24 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 614 |
| Number Of Beneficiaries Age 65 to 74 | 738 |
| Number Of Beneficiaries Age 75 to 84 | 605 |
| Number Of Beneficiaries Age Greater 84 | 505 |
| Number Of Female Beneficiaries | 1390 |
| Number Of Male Beneficiaries | 1072 |
| Number Of Non Hispanic White Beneficiaries | 1331 |
| Number Of Black or African American Beneficiaries | 1076 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1546 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 916 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 47 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.9213 |