National Provider Identifier [NPI]: |
1538117999 |
Last Name Of The Provider |
GUPTA |
First Name Of The Provider |
SANJAY |
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 |
60 OLD NEW MILFORD RD |
Street Address 2 Of The Provider |
SUITE 3G |
City Of The Provider |
BROOKFIELD |
Zip Code Of The Provider |
068042430 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
130 |
Number Of Services |
4869 |
Number Of Medicare Beneficiaries |
862 |
Total Submitted Charge Amount |
2247947.5 |
Total Medicare Allowed Amount |
577385.78 |
Total Medicare Payment Amount |
441314.34 |
Total Medicare Standardized Payment Amount |
406726.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
933 |
Number Of Medicare Beneficiaries With Drug Services |
251 |
Total Drug Submitted ChargeAmount |
137785 |
Total Drug Medicare AllowedAmount |
45175.38 |
Total Drug Medicare PaymentAmount |
35276.4 |
Total Drug Medicare Standardized Payment Amount |
35276.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
126 |
Number Of Medical Services |
3936 |
Number Of Medicare Beneficiaries With Medical Services |
862 |
Total Medical Submitted Charge Amount |
2110162.5 |
Total Medical Medicare Allowed Amount |
532210.4 |
Total Medical Medicare Payment Amount |
406037.94 |
Total Medical Medicare Standardized Payment Amount |
371449.93 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
379 |
Number Of Beneficiaries Age 75 to 84 |
298 |
Number Of Beneficiaries Age Greater 84 |
139 |
Number Of Female Beneficiaries |
549 |
Number Of Male Beneficiaries |
313 |
Number Of Non Hispanic White Beneficiaries |
796 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
738 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1646 |