| National Provider Identifier [NPI]: | 1275518581 |
| Last Name Of The Provider | GOBURDHUN |
| First Name Of The Provider | VIJAY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14555 LEVAN RD |
| Street Address 2 Of The Provider | SUITE 403 |
| City Of The Provider | LIVONIA |
| Zip Code Of The Provider | 481545083 |
| 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 | 36 |
| Number Of Services | 6082 |
| Number Of Medicare Beneficiaries | 2330 |
| Total Submitted Charge Amount | 375511.8 |
| Total Medicare Allowed Amount | 184433.13 |
| Total Medicare Payment Amount | 135733.67 |
| Total Medicare Standardized Payment Amount | 130609.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 160 |
| Number Of Medicare Beneficiaries With Drug Services | 138 |
| Total Drug Submitted ChargeAmount | 5697.8 |
| Total Drug Medicare AllowedAmount | 3713.2 |
| Total Drug Medicare PaymentAmount | 3635.19 |
| Total Drug Medicare Standardized Payment Amount | 3635.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 5922 |
| Number Of Medicare Beneficiaries With Medical Services | 2330 |
| Total Medical Submitted Charge Amount | 369814 |
| Total Medical Medicare Allowed Amount | 180719.93 |
| Total Medical Medicare Payment Amount | 132098.48 |
| Total Medical Medicare Standardized Payment Amount | 126973.85 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 382 |
| Number Of Beneficiaries Age 65 to 74 | 545 |
| Number Of Beneficiaries Age 75 to 84 | 678 |
| Number Of Beneficiaries Age Greater 84 | 725 |
| Number Of Female Beneficiaries | 1402 |
| Number Of Male Beneficiaries | 928 |
| Number Of Non Hispanic White Beneficiaries | 1961 |
| Number Of Black or African American Beneficiaries | 267 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1818 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 512 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.3604 |